Nosocomial pneumonia in immunosuppressed patients

Pulmonary infections represent the main cause of complications and one of the most important causes of mortality in immunocompromised patients. Clinical management of these infections is a complex challenge because virtually any microorganism may affect any immunocompromised patient at any time in the evolution. The high associated mortality requires a rapid and sometimes invasive diagnostic approach to try to obtain an etiologic diagnosis allowing the early introduction of specific treatment. This article describes the myriad of potential pathogens that may cause nosocomial pneumonia in non-HIV immunocompromised patients; recent developments in diagnostic tests, including noninvasive and bronchoscopic techniques; and new therapeutic approaches. The importance of an adequate assessment of risk factors with special emphasis on the potential prognostic implications of an early diagnosis is underlined.