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However, the differential diagnosis is broad, and a causative microbial agent remains undetected in the majority of cases. Pulmonary side effects from cytotoxic treatment or pulmonary involvement by the underlying malignancy must always be taken into account and may provide grounds for invasive diagnostic procedures in selected patients. <jats:italic>Pneumocystis jirovecii<\/jats:italic> (in patients not receiving co\u2010trimoxazole as prophylaxis), multi\u2010resistant gram\u2010negative bacilli, mycobacteria or respiratory viruses may be involved. High\u2010risk patients may be infected by filamentous fungi, such as <jats:italic>Aspergillus<\/jats:italic> spp., but these infections are seldom proven when treatment is initiated. Microorganisms isolated from cultures of blood, bronchoalveolar lavage or respiratory secretions need careful interpretation as they may be irrelevant for determining the aetiology of pulmonary infiltrates, particularly when cultures yield coagulase\u2010negative staphylococci, enterococci or <jats:italic>Candida<\/jats:italic> species. Non\u2010culture based diagnostics for detecting Aspergillus galactomannan, beta\u2010D\u2010glucan or <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> from blood, bronchoalveolar lavage or tissue samples can facilitate the diagnosis, but must always be interpreted in the context of clinical and imaging findings. Systemic antifungal treatment with mould\u2010active agents, given in combination with broad\u2010spectrum antibiotics, improves clinical outcome when given pre\u2010emptively. Co\u2010trimoxazole remains the first\u2010line treatment for <jats:italic>Pneumocystis<\/jats:italic> pneumonia, while cytomegalovirus pneumonia will respond to ganciclovir or foscarnet in most cases. The clinical outcome of acute respiratory failure can also be successful with proper intensive care, when indicated.<\/jats:p>","DOI":"10.1111\/bjh.13934","type":"journal-article","created":{"date-parts":[[2016,1,5]],"date-time":"2016-01-05T14:16:00Z","timestamp":1452003360000},"page":"179-189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["How to manage lung infiltrates in adults suffering from haematological malignancies outside allogeneic haematopoietic stem cell transplantation"],"prefix":"10.1111","volume":"173","author":[{"given":"Georg","family":"Maschmeyer","sequence":"first","affiliation":[{"name":"Department of Haematology, Oncology and Palliative Care Klinikum Ernst von Bergmann Potsdam Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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