10.1 Immunocompromised Host Flashcards
How can a an underlying immune deficiency be suggested clinically?
SPUR
What does the ‘S’ in SPUR stand for?
Severe- the diseases a patient is getting are life-threatening or require hospitalisation
What does the ‘P’ in SPUR stand for?
Persistence- the infection does not go away despite treatment
What does the ‘U’ in SPUR stand for?
Unusual- the infections a patient is getting are from abnormal microorganisms or are effecting an abnormal site
What does the ‘R’ in SPUR stand for?
Recurrent- the infections keep recurring in the same patient
What is primary immunodeficiency?
Due to an intrinsic defect such as a gene disorder or polymorphism
How are primary ID classified?
Classified by the defected immune component eg. B cells
What is common variable immunodeficiency?
Inability of B cells to mature into plasma cells
How do B cell ID present?
Recurrent respiratory bacterial infections
GI complications
Increased autoimmune diseases
How are B cell ID managed?
Prompt/prophylactic antibiotics
Manage respiratory function
Immunoglobulin replacement therapy
What is chronic granulomatous disease (CGD)?
Lack of respiratory burst from phagocytes so engulfed pathogens cannot be killed
What is leukocyte adhesion deficiency (LAD)?
Lack of CD18 protein on phagocytes so they cannot adhere to the epithelium or migrate to the site of infection
How do phagocyte IDs present?
Prolonged and recurrent infections
How can phagocyte ID be managed?
Prophylactic antibiotics and antifungals
Surgery
Steroids
Stem cell transportation
What is Severe Combined Immunodeficiency (SCID)?
A defect in stem cells or defective T cell development to mean leukocyte numbers are very low.
