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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2019; 40(03): 386-390
DOI: 10.4103/ijmpo.ijmpo_39_18
Original Article

Evaluation of Pulmonary Infiltrate in Febrile Neutropenic Patients of Hematologic Malignancies

Chandan K Das
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
,
Ajay Gogia
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
,
Lalit Kumar
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
,
Atul Sharma
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
,
Sanjay Thulkar
Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
,
Immaculata Xess
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
,
Karan Madan
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Background: Pulmonary infection is the major risk during neutropenia induced by chemotherapy as well as stem cell transplantation. In spite of potent new-generation antifungal and broad-spectrum antibiotics, one-third of patients usually die from infectious complications. Early diagnosis and prompt administration of appropriate therapy improve the survival. Materials and Methods: We prospectively carried out the study to identify the infectious etiology of pulmonary infiltrates in febrile neutropenia patients by imaging and bronchoscopy. Bacterial culture, fungal culture, galactomannan and molecular diagnosis for pneumocystis, and other infectious agent were carried out in the bronchoalveolar lavage (BAL) fluid and blood. Results: A total of 27 patients were evaluated. Half of the patients belonged to acute leukemia (46%). We had a diagnostic yield of 65% with the most common isolates being Gram-negative bacteria and Aspergillus species. Conclusion: Gram-negative organisms were the predominant infectious agents of pulmonary infection. Our finding emphasizes the importance of BAL in evaluating pulmonary infiltrates in neutropenic patients with hematological malignancies.

Keywords

Hematological malignancies - infection - pulmonary infiltrate


Publication History

Received: 18 February 2018

Accepted: 21 June 2018

Article published online:
03 June 2021

© 2019. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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