The development of pneumonia in patients with CLL is promoted by acute viral respiratory diseases. In the overwhelming majority of cases, pneumonia begins as focal, less frequently as lobar. However, pneumonic focus tends to spread rapidly. Often, having begun as a one-sided, pneumonia quickly spreads to another light. Pneumonia in CLL may be the first clinical symptom of the disease . Repeated pneumonia occurs in 75% of patients with CLL . The state of health of patients is sharply worsening. A patient with full somatic compensation for several hours turns into an extremely serious patient. Extrapulmonary manifestations of pneumonia predominate – fever, chills, tachycardia. . Dyspnea predominates among pulmonary manifestations. Often the disease makes its debut with a picture of endotoxic shock . Septicemia and septic shock are leading as causes of mortality among hospitalized patients with leukemia and lymphomas . The cause of septicemia can be enterococci, streptococci , or pyocyanic stick . The latent version of pneumonia in patients with chronic lymphoproliferative tumors has to be differentiated with specific tumorous lesions of the lungs .
L. Rome et. al. (2001) identified factors that contribute to the protracted course of community-acquired pneumonia . Among them, CLL patients are characterized by at least 7 factors: elderly age, the presence of a tumor neoplasm, suppression of T-cell activity, a decrease in the level of IgM, prolonged therapy with cytostatics, systemic glucocorticoids, and the presence of concomitant pathology.
Particular attention is paid to the occurrence of hospital pneumonia in patients with CLL. Nosocomial pneumonia develops in 37.1% of hospitalized hemoblastosis patients and in more than 60% of cases is fatal . Hospital pneumonia is distinguished by a large variety of etiological agents, including gram-negative flora (enterobacteria, pseudomonas bacillus, acinetobacter, etc.) and Staphylococcus aureus, which largely accounts for their severe course . Infectious complications in the hematological clinic often have the character of public- acquired infections. In specialized hematology hospitals, where patients with pronounced immunosuppression and new pathogenic pathogen pathogens appear, very often flare up “epidemics” . Therefore, it is considered necessary to hospitalize CLL patients in hospitals only for life reasons .
It should be borne in mind that in CLL, due to the lack of granulocytes in the tissues of pneumonia, a limited inflammatory focus is not always formed, giving a clear physical and X-ray picture even from 2 to 4 days after the onset of pneumonia . According to M.A. Volkova, only in 6% of patients with complicated, especially in the initial period, the course of CLL on radiographs of the lungs showed inflammatory foci. Computer tomography contributes to more accurate diagnostics . It is quite obvious that in CLL, the problem of improving the methods of early diagnosis of inflammatory and leukemic lesions of the bronchopulmonary system, contributing to the most effective treatment of complications, is relevant.