PULMONARY INFECTIONS IN IMMUNE-DEFICIENCY STATES OTHER THAN AIDS - ORGAN AND BONE-MARROW GRAFTS, THERAPEUTIC IMMUNOSUPPRESSION

Organ and bone marrow graft: In the early stages after organ or bone m arrow graft, bacterial and aspergillosis pulmonary infections are the predominant infectious complications. The risk is increased with major and prolonged neutropenia. Viral infections: Most viruses have a pulm onary tropism. Cytomegalovirus infection occurs between the first and sixth month, manifested by diffuse interstitial pneumonia with fever. Identification of alveolar cells containing nuclear and cytoplasmic in clusions or isolation of cytomegalovirus in bronchoalveolar lavage flu id cultures provides the diagnosis. Parasites: Toxoplasmosis or pneumo cytosis are frequent complications of organ or bone marrow transplanta tion. The risk remains throughout the period of cellular immunity defi ciency. Likewize, pneumocystosis is a common complication of inflammat ory diseases treated with steroids and methotrexate.