05-06 Immunocompromised Host: An ID Approach (Ch 23) Flashcards
I. To understand the basic defense mechanisms against infection and what defines a compromised host II. To understand the importance of determining host immune status in the assessment of infectious disease management III. To understand the types of infections associated with specific immune defects IV. To review some diagnostic, therapeutic and preventive modalities for the care of the compromised host.
1
Q
How common are primary immunodeficiency disorders?
A
1 in 10,000
2
Q
Name 11 categories of secondary (acquired) immunodeficiency.
A
- Impaired barrier defense: Skin abrasion, Mucosal damage (chemo, etc.), IV lines, drains, altered normal flora (antibiotics)
- Age
- Immunoglobulin loss: nephrotic syndrome, enteropathy, etc.
- Cancer: lymphoma, leukemia, myeloma
- Infection: HIV, CMV, EBV, hepatitis
- Autoimmune Disease: RA, SLE
- Chronic Disease: diabetes, renal failure, liver failure, malnutrition
- Splenectomy
- Medical treatments: Corticosteroid, Myelosuppressive chemotherapy, Calcineurin inhibitors, TNF-antagonists, Anti-metabolite, Monoclonal, polyclonal anti-lymphocyte therapy, Radiation
- Pregnancy
- Stress
3
Q
Infections associated w/ T-cell defects?
A
- Recurrent Thrush
- P jiroveci pneumonia
- Severe HSV and VZV recurrence
- Other indolent infx w/ opportunistic pathogen
4
Q
Infections associated w/ Ig defects?
A
- Recurrent sinopulmonary infx or bacteremia w/ encapsulated orgs (e.g. Strep pneumo, H. flu)
- Chronic GI infection/parasite – giardia
5
Q
Infections associated w/ complement defects?
A
severe recurrent Neisseria infxs
6
Q
Infections associated w/ neutrophil defects?
A
recurrent cutaneous infexs (Staph aureus, GNR, Aspergillus, Nocardia)
7
Q
Infections associated w/ integument defects (e.g. drug abuse) ?
A
(staph aureus, streptococci , GNR)
