Immunocomprised Host Flashcards
Definition of immunocompromised host?
A state in which the immune system is unable to respond appropriately and effectively to infectious microorganisms.
What are the 4 signs of an immunocompromised host?
SPUR Severe Persistent Unusual - site and microorganisms Recurrent
What are the two general causes or being immunocompromised?
Primary - congenital - missing cell protein, non-functioning components.
Secondary / acquired e.g. Chemo - loss of production, function or increase in catabolism of components.
What 3 types of malignancy can the immunocompromised host lead to?
Hodgkin
Leukaemia
Lymphoma
At what age do T cells defects generally present?
Over 6 months
What are some signs of T cell defects in IH?
Failure to thrive, reduction in weight
Deep tissue and skin abscesses
Fungi infections e.g. Candida
What pathogens tend to affect T cell defects in IH?
Viruses
Fungi - candida and aspergillus
Salmonella
What age does a phagocyte defect typically present in IH?
Under 6 months
What symptoms are presented in a phagocyte defect?
Low weight
Skin / mucous infections
Chronic Granuloma disease
Fungal infections
Why does phagocyte defect result in chronic granuloma disease?
Defect in phagocytes
No respiratory burst - phagocytes can engulf but no free radicals to kill pathogen
What pathogen affect a patient with a phagocyte defect?
Staph Aureus - skin, mucousal
Fungal infections - aspergillosis
What age would an antibody deficiency present?
6 months - 5 years
Give a common example of antibody deficiency condition.
Bruton’s
Affect B cell antibodies
Name 3 pathogens which commonly affect a patient with a antibody deficiency.
Strep
Staph
Haem Influenzae
What symptoms would a patient with an antibody deficiency experience.
Sino-respiratory
GI problems
Malignancy
What are some general signs of an immunocompromised host?
Family history Ear infections Pneumonia Sinus infections Viral - herpes, colds
What age would a complement deficiency present?
5 year to adulthood
What are some signs of a complement deficiency?
Meningitis
Sepsis
Arthritis
Pyogenic (pus) infections
What 2 pathogens commonly affect a patient with a complement deficiency?
Neisseria Meningitis
Haem Influenzae
Give 6 examples of secondary cases of an immunocompromised host.
Splenectomy Liver disease Infection e.g. HIV Chemo - neutropenia Malnutrition Increased catabolism e.g. Burns
What are some cases of a splenectomy?
Infarction
Trauma
Congenital
Sickle cell disease
What is the consequence of a splenectomy and how does this lead to an immunocompromised host?
Low macrophages
Low antibodies
Low protection against encapsulated bacteria
Life long penicillin prophylaxis
How can malignancy lead to an immunocompromised host?
Neutropenia following chemo
Pic lines a catheters - staph aureus, epidermis
Need immediate antibiotic treatment
What tests would you do if you suspect an immunocompromised host? How would these determine what type of defect the patient has?
Molecular and gene testing - family history - congenital (primary IH)
Complement test - complement deficiency
Lymphocyte count - T cell defect
Neutrophil and macrophage count and function test - phagocyte defect
Antibody level - Antibody defect
What are the 3 main treatment methods for an immunocompromised host?
Supportive - prevention, nutrition, make sure no vaccines are given
Specific - Immunoglobin replacement therapy - takes antibodies from healthy individuals e.g. In Bruton’s
Monitoring - organ tissues, malignancy
What type of pathogen is aspergillus? What does it look like micro?
Fungi
Large and multicellular
Long threads
Where does aspergillus normally reside?
In the lungs
What is the treatment for aspergillus?
Amphotericin - an antifungal - given IV
What are some signs /symptoms of Varicella-zoster virus?
Itchy vesicles Exanthem - scalp, face, limbs Abdo pain Malaise Fever Headache
What is the incubation for varicella - zoster virus?
14 - 21 days
How does shingles in an adult develop from varicella - zoster as a child?
Virus lies latent in neutrons and gang lions until patient is immunocompromised, then redevelops.
Must have varicella - zoster antibody to develop shingles
Pathogen? Varicella - zoster virus
Double stranded
Envelope
Virus
Where is varicella - zoster virus normally found the body?
Liver / spleen
How is chicken pox spread?
Respiratory droplets