Infections in IC host Flashcards
who gets more infections kids or adults
kids
Immunocompromised pts are characterized by having
more infections, increased severity of those infections, diminished response to usually effective therapy, & patterns of infections are different
what do you call an infection by an organism that normally does not cause dz but does so when IC
opportunistic infections
what are 3 agents of opportunistic infections
Pneumocystis jirovecii, Cryptococcus neoformans, Fungal infections (other than thrush and tinea)
what is the basis of primary immunodeficiency
genetic defects
what are 3 ways to get a secondary immunodeficiency
- acquired (HIV/AIDS)
- anatomic and physiologic abnormalities (congenital asplenia/splenectomy, pumonary cyst, splenectomy)
- Iatrogenic (urinary catheter, chemo)
infectious symptoms begin in first days-weeks of life
primary immunodeficiency
infection is often suppressed rather than eradicated by appropriate therapy
primary immunodeficiency
growth and development are commonly delayed
primary immunodeficiency
on a cellular level what is going on in primary immunodeficiency
- innate immunity: prob with phagocytes and compliment
- b lymphocytes: dysfxn in Ig prod & fxn
- t lymphocytes: can impact b cell fxn
absence of neutrophils
kostmann’s congenital neutropenia (primary immunodeficiency)
neutrophil level fluctuates up and down
cyclic neutropenia
what bug can infect w/ neutrophil abnormalities
Aspergillus, candida, bacteria
C1-C4 deficiency
AI disorders
C5-C9 deficiency
neisseria spp. infection
properidin deficiency
neisseria spp. infection
how do you treat complement deficiency
immunizations and antibiotics if needed
defective BTK (bruton tyrosine kinase)
x-linked agammaglobulinemia
2-20 y/o w/ recurrent infections
CVID
what is the MC immunodeficiency
IgA deficiency
what do you not want to do in IgA deficiency
IgG replacement!!!!!!!!!!
No Tcells w/ effects on Bcell fxn
SCID
how do you tx SCID
stem cell transplant
congenital thymic hypoplasia, heart dz, hypoparathyroidism, neonatal hypocalcemia
Digeorge syndrome
neonatal hypocalcemia
Digeorge syndrome
what is a major late complication of digeorge syndrome
AI disorder late in life
thrombocytopenia, severe eczema
wiscott-aldridge syndrome
high risk for lymphoma
wiscott aldridge
how do you treat wiscott aldridge
stem cell transplant
what infections do you see with lymphocytic disorders
pneumocystis pneumonia; fungal infections; protozoal infections; disseminated viral infections; bacterial infection, malignancy
oral live attenuated vaccine in kid w/ SCID
polio
gets infection w/ catalase positive bacteria and fungi
phagocyte deficiency
gets neisseria infections
complement deficiency (C5-9)
gets infected w/ organisms w/ polysaccharide capsules
Ab deficiency (b cell)
gets opportunistic infections fungi and viruses
cellular and combined immunodeficiencies
kid comes in with recurrent URI
normal
what are you at risk for with either splenectomy or sickle cell dz
sepsis w/ encapsulated bacteria (ESP. S pneumonia!!!!!!!! ; and H flu)
Digeorge syndrome
Neonatal hypocalcemia !!!!!!!!
3 complications associated w/ pregnancy
UTI, HepE, H1N1 flu
what would you see clinically w/ chemo induced immunodeficiency
bacterial/candidal infection; aspergillosis, pneumocystic pneumonia, disseminated varicella
what are you worried about with transplant
risk of neutropenia plus profound lymphocytic dysfxn
partial albanism
chidiak hagashi
pseudomonas infection
leukemia
