Interstitial Pneumonitis

Interstitial pneumonitis is an important complication and may be due to any of the following causes:

• Pneumocystis carinii

• Undiagnosed infections (e.g., fungal)

• Radiation toxicity

• Immune reactions involving the lung

The mortality rate for interstitial pneumonitis is 60%. The use of prophylactic Bactrim has reduced P. carinii infection to less than 2%.

After 120 days post-HSCT, the most common infections are sinopulmonary infections with encapsulated organisms and cutaneous infections with herpes zoster. Other localized or disseminated viral infections that occur include adenovirus, herpes simplex virus, varicella virus, and respiratory syncytial virus.

Table 25-15 outlines the management of infection during stem cell transplantation and post-transplantation.

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