CHAPTER 12. Pneumonia in the Cancer Patients by Scott E. Evans, Amar Safdar

ABSTRACT

Lower respiratory tract infections result in unacceptably high mortality among cancer patients.  Pneumonias cause death in this population both directly through impairment of gas exchange and progression to system infection/sepsis, as well as indirectly by precluding delivery of necessary, but immuncompromising, anti-neoplastic therapies.^1-3  Malignancy and treatment-related impairments of host immune responses and the emergence of multidrug-resistant (MDR) organisms associated with recurrent exposures to hospital environments may not only enhance the risks of mortality, but also exacerbate the difficulty of diagnosing pneumonia in the cancer setting.  As a consequence of disordered inflammatory responses, the typical clinical observations of pneumonia, including purulent respiratory secretions and early radiographic findings may be in apparent or absent.  A comprehensive review of etiology, clinical presentation, diagnosis and management of pulmonary infections is presented in this chapter.