eprintid: 10180434 rev_number: 11 eprint_status: archive userid: 699 dir: disk0/10/18/04/34 datestamp: 2023-11-06 13:13:30 lastmod: 2024-10-04 06:10:05 status_changed: 2023-11-06 13:13:30 type: article metadata_visibility: show sword_depositor: 699 creators_name: Pates, Katharine M creators_name: Periselneris, Jimstan N creators_name: Brown, Jeremy S title: Opportunistic bacterial, viral and fungal infections of the lung ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: K71 keywords: Aspergillus; Cryptococcus; fungi; immunocompromised host; Nocardia; opportunistic infections; pneumonia; viruses note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Respiratory opportunistic infections are a major cause of morbidity and mortality in severely immunocompromised patients, such as those treated with biological therapies, chemotherapy and solid organ or stem cell transplants, and those with haematological malignancy, aplastic anaemia or HIV infection. The type and degree of immune defect dictates the profile of potential opportunistic pathogens; T-cell-mediated defects increase the risk of viral (cytomegalovirus, respiratory viruses) and Pneumocystis jirovecii infections, whereas neutrophil defects are associated with bacterial pneumonia and invasive aspergillosis. However, patients often have combinations of immune defects, and a wide range of other opportunistic infections can cause pneumonia. Importantly, conventional non-opportunistic pathogens are also frequently encountered in immunocompromised hosts and should not be overlooked. The radiological pattern of disease (best assessed by computed tomography) and speed of onset help identify the likely pathogen(s); this can then be supported by targeted investigation including early use of bronchoscopy in selected patients. Rapid and expert clinical assessment can help identify the most likely pathogens, allowing timely appropriate therapy. date: 2023-11 date_type: published publisher: Elsevier BV official_url: https://doi.org/10.1016/j.mpmed.2023.08.002 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2097984 doi: 10.1016/j.mpmed.2023.08.002 lyricists_name: Brown, Jeremy lyricists_id: JBROW91 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: Medicine volume: 51 number: 11 pagerange: 777-783 issn: 1357-3039 citation: Pates, Katharine M; Periselneris, Jimstan N; Brown, Jeremy S; (2023) Opportunistic bacterial, viral and fungal infections of the lung. Medicine , 51 (11) pp. 777-783. 10.1016/j.mpmed.2023.08.002 <https://doi.org/10.1016/j.mpmed.2023.08.002>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10180434/1/Brown_Opportunistic%20bacterial%2C%20viral%20and%20fungal%20infections%20of%20the%20lung.pdf