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Cough in the immunocompromised host: ACCP evidence-based clinical practice guidelines
Chest
|January 24, 2006
Summary
Patients with compromised immune systems experiencing chronic cough should first be evaluated for common causes. Opportunistic infections are considered if initial diagnostics for general populations do not identify the cause of cough.
Area of Science:
- Pulmonology
- Infectious Diseases
- Immunology
Background:
- Chronic cough is a common complaint in immunocompromised patients.
- These patients are at increased risk for opportunistic infections.
- Common causes of cough should also be investigated.
Purpose of the Study:
- To review the differential diagnosis of chronic cough in immunocompromised patients.
- To outline an appropriate diagnostic approach for this patient population.
Main Methods:
- A literature search was conducted using MEDLINE.
- Search terms included "cough," "immunocompromise," "HIV," "AIDS," "neutropenia," and "corticosteroids."
- The search covered publications from 1966 to 2003.
Main Results:
- Immunocompromised patients with chronic cough often have common causes similar to the general population.
- The specific immune defect can influence the likelihood of encountering unusual infections.
- A variety of infections, typically seen in immunocompetent hosts, may occur.
Conclusions:
- Initial diagnostic evaluation for cough in immunocompromised patients should mirror that of healthy individuals.
- Opportunistic infections should be considered once common causes have been ruled out.
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