Chest
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Editorial Comment
Chronic Mountain Sickness Evolving Over Time: New Data From on High.
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Despite substantial progress in long-term follow-up strategies for lung transplant recipients, morbidity and mortality remain high, mostly because of the elevated infectious risk and the development of chronic lung allograft dysfunction. The high immunosuppressive levels necessary to prevent acute rejection and the graft's constant exposure to the environment come at the high price of frequent infectious complications. ⋯ However, these are challenging endeavors because of the vast spectrum of possible pathogens and the discrete clinical features resulting form transplant recipients' impaired immune responses. This review proposes a stratified diagnostic strategy and discusses the most relevant pathogens and the corresponding therapeutic approaches, while also offering insight on infection prevention strategies: vaccination, prophylaxis, pre-emptive therapy, and antibiotic stewardship.