ABSTRACT
This chapter describes the pulmonary complications that develop in haematopoietic stem-cell transplantation (HSCT) recipients. When HSCT recipients present with pulmonary infiltrates and signs of infection, most clinicians initiate empiric antibacterial therapy, adding antifungal treatment if risk factors are present and there is no response to initial treatment. Risk factors for the development of pulmonary complications include pre-transplant radiation and chemotherapy, total body irradiation, an allogeneic stem-cell source, and graft-versus-host disease. The frequency of Cytomegalovirus (CMV) pneumonia in the early post-transplantation period has been substantially reduced by prophylaxis. The use of CMV seronegative blood products and leucocytedepleted platelets can reduce the rate of CMV infection in CMV seronegative HSCT recipients. Although varicella zoster virus infection is common in HSCT recipients after engraftment, it rarely causes disseminated disease. The diagnostic work-up of HSCT recipients with suspected pulmonary aspergillosis should include a procedure intended to obtain tissue for histology and culture.
