Không thể để thiết lập chẩn đoán xác định mà không cần rửa phế quản / mô. Trình tự thời gian cấy ghép sau khi thay đổi với parainfluenza. Hình ảnh X-ray là viêm phổi do virus khác. 5. Chẩn đoán nghiên cứu a) xoang phim và ngực x-ray b) parainfluenza | Page 179 coryza wheezing and shortness of breath. Sinus films may reveal opacification. Chest x-ray reveals diffuse interstitial pulmonary infiltrates. Arterial blood gases show hypoxemia. 4. Differential diagnosis a Bacterial pneumonia especially atypical bacterial or Legionella pneumonia b Fungi C. neoformans Candida species aspergillosis coccidioidomycosis c Protozoa PCP T. gondii d Viral HSV VZV RSV Unable to establish definitive diagnosis without bronchoalveolar lavage tissue. Time sequence post-transplant varies with parainfluenza. X-ray picture is that of other viral pneumonias. 5. Diagnostic studies a Sinus films and chest x-ray b Parainfluenza culture nasopharyngeal throat or bronchoalveolar lavage sample with onset of upper or lower tract symptoms. Is often underdiagnosed due to poor culturing techniques in the past. c Pulmonary Bronchoalveolar lavage open lung biopsy for culture. Specimens ------------------should also be sent for pathology bacterial and fungal cultures viral culture immunofluorescent antibody or rapid shell silver stain acid-fast bacteria Mycoplasma and Legionella. 6. Management a Aerosolized ribavirin has been used with some success if used early in the ------------------disease. Administer by aerosol 12 to 18 hours daily for 3 to 7 days. Dilute 6-g vial in 300 mL preservative-free sterile water to a final concentration of 20 mg mL. Must be administered with Viratek Small Particle Generator Page 180 SPAG-2 . b Intravenous immune globulin my be used although efficacy is unknown. c Treat hypoxemia oxygen support mechanical ventilation if needed. T. Respiratory syncytial virus RSV infection 28 29 30 -------1. Definition viral infection affecting the upper and lower respiratory tracts common in healthy children. Increasing prevalence in BMT and other immunocompromised patients 2. Risk factors a Allogeneic BMT recipients b Children less than 12 to 18 months of age c Pretransplant immunosuppression d GVHD on steroids e Chronic lung disease .
