Opportunistic Infections in Immunocompromised Host

Question 1

• What is an opportunistic infection?

Answer 1

An infection that affects an immunocompromised host, that otherwise wouldn’t affect a healthy individual

Question 2

• What is the most common cause of neutropaenia?

Answer 2

Chemotherapy

Question 3

• How do people with neutropenic sepsis present?

Answer 3

o Neutrophils <0.5x109/l
o Temperature >38°C
o Other vital signs consistent with sepsis

Question 4

• What type of infections do immunocompromised hosts get in the following situation?

1.Lower respiratory tract
2.Skin
3Mucosal surface

Answer 4

1. Aspergillus
2. Pseudomonas aeruginosa. Candida
3. # Coagulase-negative staphylococci

Question 5

What is invasive aspergillosis?

Answer 5

A fungal infection due to everyday environmental mould which you get through inhalation of spores. Aspergillus is found on rotting fruit. Typically causes a LRTI.

Question 6

• What are you suspecting if you find a fever in someone who is neutropaenic?

Answer 6

Sepsis until proven otherwise

Question 7

• What is the go-to antibiotic in neutropenic sepsis?

Answer 7

Piperacillin/tazobactam (a.k.a. Tazocin)

Question 8

• What is the go-to antibiotic for MRSA?

Answer 8

Vancomycin

Question 9

• How can we prevent infection in neutropenic patients?

Answer 9

Giving prophylactic ciprofloxacin in the period that we know they will be most vulnerable (e.g. 7-12 days after chemotherapy)

Question 10

• What are the 2 main infections that a T-cell immunocompromised host will have?

1. causes pneumonia. Classic in HIV.
2. encapsulated yeast found in bird droppings that causes meningitis in the immunocompromised

Answer 10

1. Pneumocystis jirovecii

2. Cryptococcus neoformans

Question 11

How can reactivation of herpes virus infection be prevented?

Answer 11

Can be prevented using prophylactic aciclovir +/- immunisation

Question 12

What are Haemophilus influenzae
Neisseria meningitidis
Streptococcus pneumoniae
all sensitive to?

Answer 12

Penicillin

Used in prophylaxis in certain patients with B cell immunocompromisation.

Question 13

• What is the most common type of candidiasis?
• Is candida a normal human commensal?
• What type of infections does it cause:
• everyone?
• immunocompromised?

Answer 13

Due to Candida albicans

yes

o Mucosal thrush (in everyone)
o Bloodstream infections (in the immunocompromised)