First Things First (assess & treat for the following)

• Rapid assessment of vital signs, including oxygen saturation and tissue perfusion
• Potential etiologies:
  • Common, community-acquired bacterial and viral diseases
  • Uncommon opportunistic infections
  • Multiple simultaneous processes are common.
• Early imaging (CT scan) and tissue-based diagnosis (histopathology and cultures) are critical to survival of the immunocompromised patient with pneumonia.
• Microbicidal therapy must be started as soon as possible.
• Inflammatory responses are impaired by immunosuppressive therapy, which results in diminished symptoms and muted clinical and radiologic findings.
• Infections are often advanced (ie, disseminated) at the time of clinical presentation.
• The choice of antimicrobial regimens is often more complex.
• Antimicrobial resistance is increased.
• Surgical intervention is often necessary.