CTICasesAspiration Pneumonia (Jamella haemolysans) in Stem Cell Transplant Patient with Mucositis
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Imaging findings
Chest radiograph showed consolidation in the lung bases with some associated septal lines. CT imaging revealed characteristic tree-in-bud opacities and peribronchial consolidation, predominantly in an airway distribution. Pleural effusions and edema were also noted.
Key takeaways
Stem cell transplant recipients, particularly those with severe mucositis, neutropenia, and often on narcotics, are prone to aspiration pneumonia due to impaired secretion control. The imaging pattern of basal, central consolidation with tree-in-bud opacities is highly suggestive of aspiration. The isolated growth of *Jamella haemolysans*, a normal oral flora organism, suggests an opportunistic infection from aspiration. It is important to recognize this pattern to avoid over-aggressive treatment for what might be low-grade aspiration-related inflammation, often compounded by volume overload and atelectasis.
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