A 52-year-old man underwent hematopoietic stem cell transplantation for advanced lymphoma. A month later he presents with dyspnea and fever. On examination bilateral crepitations were noted. He was hypotensive and required mechanical ventilation. Investigations reveal hemoglobin 7 gm/dl, neutropenia and thrombocytopenia. Chest X-ray reveals diffuse alveolar opacities. Blood cultures grew Klebsiella pneumoniae.
Patient was treated with carbapenems but the respiratory symptoms continued. Bronchoscopy with broncho alveolar lavage was performed. Gram’s stain of BAL is shown. What is the required treatment according to the BAL finding? Source: Gupta et al. BMC Cancer2006 6:87
