Pneumonias associated with acquired immunodeficiency states

This monograph provides a comprehensive overview of pneumonia in immunocompromised patients, with particular emphasis on pathophysiological mechanisms, diagnostic challenges, and contemporary therapeutic approaches.

The introductory chapters describe the natural defense mechanisms of the respiratory system, including mucociliary clearance, alveolar macrophages, surfactant proteins, and innate and adaptive immune responses, which constitute the primary defense against respiratory pathogens.

Special attention is given to the pathogenesis of pneumonia, highlighting the interaction between microbial virulence, host immune status, and the pulmonary microbiome in the development of infection. Primary and secondary immunodeficiencies are discussed in detail, including their classification, etiology, clinical characteristics, and the most common pathogens associated with specific immune defects.

The monograph systematically classifies pneumonia according to the setting in which it is acquired, distinguishing community-acquired, hospital-acquired, healthcare-associated, and ventilator-associated pneumonia, while outlining their epidemiological and clinical characteristics.

The central part of the monograph focuses on pneumonia in immunocompromised patients. It discusses the major risk factors, the most common opportunistic and conventional pathogens according to the type of immunodeficiency, characteristic clinical manifestations, and the specific features of radiological and microbiological diagnosis. Particular emphasis is placed on the timely assessment of the degree of immunosuppression, the application of modern diagnostic techniques—including computed tomography, bronchoscopy, and bronchoalveolar lavage—and the rational selection of empirical and targeted antimicrobial therapy.

In addition to diagnosis and treatment, the monograph addresses preventive strategies, including vaccination, antimicrobial prophylaxis, and risk factor control, all of which play a crucial role in reducing the incidence and mortality of infections in immunocompromised patients. Particular importance is attributed to a multidisciplinary approach involving pulmonologists, infectious disease specialists, hematologists, oncologists, microbiologists, and radiologists.

Based on current scientific evidence and international guidelines, this monograph represents a contemporary, practice-oriented reference intended for specialists and residents in pulmonology, infectious diseases, internal medicine, hematology, oncology, and intensive care medicine, as well as for all healthcare professionals involved in the diagnosis, treatment, and prevention of respiratory infections in immunocompromised patients.