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Romanian Journal of Internal Medicine

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2501-062X
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Transthoracic ultrasonography for the immunocompromised patient. A pilot project that introduces transthoracic ultrasonography for the follow-up of hematological patients in Romania

Ioana Frinc
  • Department of Hematology, “Ion Chiricuţă” Oncology Institute, Cluj-Napoca, Romania
  • Department of Hematology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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/ Petru Ilies / Florin Zaharie
  • Department of Surgery, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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/ Delia Dima / Alina Tanase / Ljubomir Petrov / Alexandru Irimie
  • Department of Surgery, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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/ Cristian Berce
  • Department of Surgery, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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/ Cosmin Lisencu
  • Department of Surgery, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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/ Ioana Berindan-Neagoe / Ciprian Tomuleasa
  • Corresponding author
  • Department of Hematology, “Ion Chiricuţă” Oncology Institute, Cluj-Napoca, Romania
  • Department of Hematology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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/ Anca Bojan
  • Department of Hematology, “Ion Chiricuţă” Oncology Institute, Cluj-Napoca, Romania
  • Department of Hematology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Published Online: 2017-06-06 | DOI: https://doi.org/10.1515/rjim-2017-0006

Abstract

In the past decade, there has been significant progress in clinical hematology with the discovery of targeted molecules and thus the achievement of both hematologic and molecular responses. Nevertheless, chemotherapy remains the treatment of choice for many types of hematological malignancies. Aggressive chemotherapy leads to immunosuppression, accompanied by a high rate of infections and an increased rate of treatment-related mortality. Invasive fungal infections as well as more common bacterial and viral infections are frequent in immunocompromised patients as they are difficult to diagnose and treat. Pleuropulmonary infections in immunocompromised patients are diagnosed using clinical examination, imaging and laboratory tests. Many laboratory tests are run for several days before a final result is given and are expensive. Computer tomography is a reliable technique, but it is encumbered by high irradiation and high cost, and can assess lesions larger than 1 cm. Transthoracic ultrasound is a modern method, used in the diagnostic algorithm of pleuropulmonary pathology. It allows the diagnosis of small lesions, can be performed at the patients’ bedside, with acceptable costs and no irradiation. A fast, informed and accurate medical decision is essential for a favorable outcome in immunosuppressed patients with an adjacent infection. In the current case series we present the implementation of a new protocol for the follow-up of immunocompromised patients using transthoracic ultrasonography, of great potential use in the clinic.

Keywords: hematological malignancies; immunosuppression; transthoracic ultrasound; antibiotics; antifungal treatment

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About the article

Received: 2016-10-05

Published Online: 2017-06-06

Published in Print: 2017-06-01


Citation Information: Romanian Journal of Internal Medicine, ISSN (Online) 2501-062X, DOI: https://doi.org/10.1515/rjim-2017-0006.

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© 2017 Ioana Frinc et al., published by De Gruyter Open. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. BY-NC-ND 3.0

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