Clinical Case Database / Category: Patient Management
Pneumonia in the immunosuppressed: a medical emergency
Publication details
Dr Gemma Hayes, Dr Nicholas Withers
Foundation Years Journal, volume 5, issue 9, p.60 (123Doc Education, London, October 2011)
Abstract
A sixty one year old female with no significant past medical history, underwent cadaveric renal transplantation for end stage renal failure secondary to adult polycystic kidney disease. Following transplantation she was treated with prednisolone and tacrolimus to prevent graft rejection and the perioperative period was uncomplicated. Subsequently she suffered from intermittent neutropaenia due to heavy immunosuppression and the acquisition of cytomegalovirus. This caused further marrow suppression and two episodes of CMV pneumonitis, treated with valganciclovir.
Access the Clinical Cases Database
A subscription is required to read the full article. Please subscribe using one of the options below.
| Product | Price | Subscription | |
|---|---|---|---|
| Foundation Years Clinical Cases Database | £29.00 | 6 months | |
| Foundation Years Clinical Cases Database | £39.00 | 12 months |
Authors
Dr Gemma Hayes
StR Respiratory Medicine
Dr Nicholas Withers
Consultant in Respiratory Medicine
Royal Devon and Exeter NHS Foundation Trust
References
1. Rubin, RH, Greene, R. Clinical approach to the compromised host with fever and pulmonary infiltrates. In: Clinical Approach to Infection in the Compromised Host, 3rd edition, Rubin, RH, Young, LS (Eds). Plenum Press, New York 1994. p.121.
2. Rosenow EC. Diffuse pulmonary infiltrates in the immunocompromised host.Clin Chest Med. 1990;11(1):55-64.
3. Fishman JA, Rubin RH. Infection in organ-transplant recipients.N Engl J Med. 1998;338(24):1741-51.
4. Groll AH, Shah PM, Mentzel C, Schneider M, Just-Nuebling G, Huebner K.
Trends in the postmortem epidemiology of invasive fungal infections at a university hospital. J Infect. 1996;33(1):23-32.
5. Collin BA, Ramphal R.Pneumonia in the compromised host including cancer patients and transplant patients.Infect Dis Clin North Am. 1998;12(3):781-805, xi.
6. N Bell and A Whittle. Pneumonia in the non HIV immune compromised patient. In Maskell and Millar eds. Oxford Desk Reference Respiratory Medicine, 1st edition. Oxford University Press 2009.
7. A Dunleavy, M Lipman and R Miller. Infection in the HIV compromised Host. In Maskell and Millar eds. Oxford Desk Reference Respiratory Medicine, 1st edition. Oxford University Press 200.
8. www.survivingsepsis.org.
9. Pulmonary disease in the immunocompromised (non-HIV). In Chapman, Robinson, Stradling and West Eds Oxford Handbook of Respiratory Medicine 2nd edition Oxford University Press.
10. Guidelines on the management of invasive fungal infection during therapy for haematological malignancy; British Committee for Standards in Haematology, Prentice et al 2008.
Disclaimers
Conflict Of Interest
The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/urm_full.pdf).
Financial Statement
The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.
Patient Consent statement
All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.
Animal & Human Rights
When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.
About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.