CHEST Guidelines-Cough-in-Ambulatory-Immunocompromised-Adults_2017

Cough-in-Ambulatory-Immunocompromised-Adults_2017_ (1)

Pdf Summary

The "Cough in Ambulatory Immunocompromised Adults" CHEST Expert Panel Report investigates the common causes of cough in immunocompromised adults with normal chest radiographs and proposes diagnostic guidelines. A systematic review was conducted to explore whether these causes differ from those in the general population.<br /><br />Key findings include the lack of high-quality evidence to distinguish the reasons for cough in immunocompromised individuals from those with normal immune systems. Consequently, the panel recommends that the initial diagnostic approach in immunocompromised patients with normal chest radiographs should mirror that used for immunocompetent patients. This includes considering common causes such as upper airway cough syndrome, asthma, and gastroesophageal reflux disease.<br /><br />Additionally, the panel advises that tuberculosis (TB) should be part of the initial evaluation for HIV-positive individuals in regions with high TB prevalence, regardless of radiographic findings. If initial evaluations yield no results, practitioners should consider specific diseases associated with the type and severity of the immune disorder.<br /><br />The report concludes with a consensus on employing similar initial diagnostic strategies for cough in immunocompromised individuals as for those with normal immune function, while factoring in regional, social, and immune deficiency specifics. The absence of quality evidence highlights the need for future studies to better understand the spectrum and frequency of cough causes in varying immunocompromised populations. These studies should aim to develop effective diagnostic algorithms to improve outcomes.<br /><br />Overall, the recommendations emphasize a consistent diagnostic approach with special considerations for regional and immune-related factors, thereby ensuring comprehensive evaluation for the diverse challenges faced by immunocompromised patients.

Keywords

immunocompromised adults

cough causes

diagnostic guidelines

chest radiographs

systematic review

upper airway cough syndrome

asthma

gastroesophageal reflux disease

tuberculosis

HIV-positive