TAILIEUCHUNG - Chapter 082. Infections in Patients with Cancer (Part 8)

Brain Masses Mass lesions of the brain most often present as headache with or without fever or neurologic abnormalities. Infections associated with mass lesions may be caused by bacteria (particularly Nocardia), fungi (particularly Cryptococcus or Aspergillus), or parasites (Toxoplasma). Epstein-Barr virus (EBV)–associated lymphoproliferative disease may also present as single or multiple mass lesions of the brain. A biopsy may be required for a definitive diagnosis. Pulmonary Infections Pneumonia (Chap. 251) in immunocompromised patients may be difficult to diagnose because conventional methods of diagnosis depend on the presence of neutrophils. Bacterial pneumonia in neutropenic patients may present without purulent sputum—or, in fact,. | Chapter 082. Infections in Patients with Cancer Part 8 Brain Masses Mass lesions of the brain most often present as headache with or without fever or neurologic abnormalities. Infections associated with mass lesions may be caused by bacteria particularly Nocardia fungi particularly Cryptococcus or Aspergillus or parasites Toxoplasma . Epstein-Barr virus EBV -associated lymphoproliferative disease may also present as single or multiple mass lesions of the brain. A biopsy may be required for a definitive diagnosis. Pulmonary Infections Pneumonia Chap. 251 in immunocompromised patients may be difficult to diagnose because conventional methods of diagnosis depend on the presence of neutrophils. Bacterial pneumonia in neutropenic patients may present without purulent sputum or in fact without any sputum at all and may not produce physical findings suggestive of chest consolidation rales or egophony . In granulocytopenic patients with persistent or recurrent fever the chest x-ray pattern may help to localize an infection and thus to determine which investigative tests and procedures should be undertaken and which therapeutic options should be considered Table 82-7 . The difficulties encountered in the management of pulmonary infiltrates relate in part to the difficulties of performing diagnostic procedures on the patients involved. When platelet counts can be increased to adequate levels by transfusion microscopic and microbiologic evaluation of the fluid obtained by endoscopic bronchial lavage is often diagnostic. Lavage fluid should be cultured for Mycoplasma Chlamydophila Legionella Nocardia more common bacterial pathogens and fungi. In addition the possibility of Pneumocystis pneumonia should be considered especially in patients with ALL or lymphoma who have not received prophylactic trimethoprim-sulfamethoxazole TMP-SMX . The characteristics of the infiltrate may be helpful in decisions about further diagnostic and therapeutic maneuvers. Nodular infiltrates suggest

• Y học thường thức
• Infections in Patients with Cancer
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu y khoa
• Harrisons Internal Medicine
• Nosocomial infection
• Intensive care unit
• Regional cancer center
• Nosocomial infections
• Molecular diagnosis of bacterial resistance
• Patients admitted
• Oncology Patients
• Cancer Illness
• Pediatric Infectious
• Fungal Infections
• Patients of Paediatric Age
• Infantile Chronic
• Mycobacterium tuberculosis direct test
• Mycobacteria growth indicator tube
• TB infections
• Cancer patients
• Conventional diagnostic methods