Related Experiment Video
Updated: Sep 14, 2026
Modeling Primary Bone Tumors and Bone Metastasis with Solid Tumor Graft Implantation into Bone
Published on: September 9, 2020
Pulmonary infections after bone marrow transplantation: clinical and radiographic findings
A N Leung1, M V Gosselin, C H Napper
1Department of Radiology, Stanford University Medical Center, CA 94305-5105, USA.
Purpose:
To assess the clinical and radiographic findings of pulmonary infections diagnosed by using invasive means.
Materials And Methods:
Fifty-nine episodes of pulmonary infection were diagnosed in 52 (7.2%) of a consecutive series of 725 adult bone marrow transplant recipients. Causative organisms, time of diagnoses, radiographic patterns, and mortality rates were reviewed.
Results:
Cytomegalovirus and Aspergillus species were the two most common pathogens, accounting for 22 and 17 episodes, respectively. During the first 30 days after bone marrow transplantation, fungi caused the majority (nine [82%] of 11 episodes) of pulmonary infections; from days 31 to 100, viruses predominated (21 [62%] of 34 episodes). Recipients of allogeneic transplants had a higher probability of developing Cytomegalovirus pneumonitis than did the recipients of autologous and syngeneic transplants (P < .001). Radiographic findings of Cytomegalovirus pneumonia consisted of parenchymal opacification (90%) and innumerable nodules smaller than 5 mm (29%); in two patients, radiographs were normal. Nodules, masses, or nodules and masses, present in nine (69%) of the 13 patients with Aspergillus infection, were the most common radiographic findings in invasive aspergillosis. Bone marrow transplant recipients with a documented pulmonary infection were found to have a lower event-free survival than recipients without infection (P < .001).
Conclusion:
Opportunistic pathogens account for the majority of pulmonary infections requiring invasive diagnosis and tend to manifest at predictable times in the course of events following recovery from bone marrow transplantation. Cytomegalovirus, the most common pathogen, causes a spectrum of radiographic findings that includes normal findings. Occurrence of a pulmonary infection is associated with an increased mortality rate.
Insights
Pulmonary infections in bone marrow transplant recipients are often caused by opportunistic pathogens like Cytomegalovirus and Aspergillus. These infections, diagnosed invasively, are linked to increased mortality rates.
Area of Science:
- Infectious Diseases
- Hematology
- Pulmonology
Background:
- Bone marrow transplantation (BMT) recipients are immunocompromised, increasing susceptibility to opportunistic infections.
- Pulmonary infections are a significant cause of morbidity and mortality in BMT patients.
- Early and accurate diagnosis of pulmonary infections is crucial for effective management.
Purpose of the Study:
- To evaluate clinical and radiographic features of pulmonary infections in BMT recipients diagnosed via invasive methods.
- To identify common pathogens, their timing, and associated radiographic patterns.
- To assess the impact of pulmonary infections on survival outcomes.
Main Methods:
- A retrospective review of 725 adult BMT recipients was conducted.
- Fifty-nine episodes of pulmonary infection diagnosed through invasive procedures were analyzed.
- Data collected included causative organisms, timing of diagnosis, radiographic findings, and mortality rates.
Main Results:
- Cytomegalovirus (CMV) and Aspergillus species were the most frequent pathogens.
- Fungal infections predominated early post-transplant (days 0-30), while viral infections (especially CMV) were more common later (days 31-100).
- CMV pneumonia presented with various radiographic patterns, including normal findings, while invasive aspergillosis often showed nodules or masses. Pulmonary infection was associated with significantly lower event-free survival (P < .001).
Conclusions:
- Opportunistic pathogens are the primary cause of pulmonary infections in BMT recipients, manifesting predictably post-transplant.
- CMV is the most common pathogen, with diverse radiographic presentations.
- Pulmonary infections significantly increase mortality risk in BMT survivors.
Related Concept Videos
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories:
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:27Pneumothorax-II
Clinical Manifestations:
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...