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Editorials |

Diagnosis and Natural History of Pulmonary Infections in Transplant Recipients

Norman W. Rizk, MD; John L. Faul, MD
Author and Funding Information

Affiliations: Stanford, CA 
 ,  Dr. Rizk is Professor of Medicine and Dr. Faul is a Fellow in Pulmonary and Critical Care Medicine, Stanford University Medical Center.

Correspondence to: Norman W. Rizk, MD, Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, 300 Pasteur Dr, RM H3142, Stanford, CA 94305-5236



Chest. 2000;117(2):303-305. doi:10.1378/chest.117.2.303
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Over the past 20 years, opportunistic lung infections have become a serious clinical problem for solid organ and bone marrow transplant (BMT) recipients, because of their immunosuppressive therapy intended to prevent allograft rejection. Without prophylactic antimicrobial therapy, transplant recipients may suffer life-threatening pulmonary infections, including Pneumocystis carinii pneumonia (PCP) and cytomegalovirus (CMV) pneumonitis. With the advent of newer immunosuppressive agents, like mycophenolate mofetil, tacrolimus, and rapamycin, the nature of immunosuppression and the accompanying susceptibility to opportunistic infection have continued to evolve. Each transplant population is unique, especially in terms of differing immunosuppressive therapies and antimicrobial prophylaxis. In general, the severity and number of serious opportunistic infections, and the consequent need for prophylaxis, are proportional to the degree of immunosuppression. When infections do occur in the absence of or despite prophylaxis, enough data now exist to make some general comments about their management.


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