Week 5: Infections in immunocompromised hosts Flashcards
When to think immune deficiency?

Common evaluation

Examples of infections in innate immune deficiency
- Chronic granulomatous disease
- Terminal complement deficiency (C5-9)
- Netropenia
- Leukocyte adhesion defects
- Job’s Syndrome
Innate immune deficiency causes
Decreased chemotaxis, diminished phagocytic capacity & defective intracellular killing
Infective etiologies of innate immune deficiency
Hepatic abscesses
Skin infections
Gingivitis
Recurrent pyrogenic infections
Infectious organisms in innate immune deficiency
- S. aureus
- CoNS
- viridans strep
- enterococcus
- E. coli
- P. aeruginosa
- Serratia
- Aspergillus
- Nocardia
Examples of humoral antibody deficiency
- X-linked agammaglobulinemia
- CVID
- CLL
- MM
- Extensive RxTx
- Chemo
humoral antibody deficiency Dx
Failure to make Ab to new Ag or even Ab after vaccines
Infectious etiologies of humoral antibody deficiency
- Recurrent sinopulmonary infections with encapsulated organisms
- Chronic diarrhea
- Aseptic meningitis
- Echoviruses
Infectious organisms of humoral antibody deficiency
- Strep pneumo
- H. influenzae
- Giardia
- Enteroviruses
- Campylobacter
- Shigella
Causes of Cellular immune deficiency
- Digeorge Syndrome
- Extensive irradiation
- Immunosuppressives (Corticosteroids, cyclosporine, tactrolimus, monoclonal Ab)
- Hoggkin’s Lymphoma
- AIDS
- CD4 lymphopenia
Infectious etiologies of Cellular immune deficiency
- Intracellular organisms
- viruses
Infectious agents of Cellular immune deficiency
- Listeria
- PJP
- Nocardia
- Mycobacteria
- Histoplasma
- Coccidiodomycosis
- Aspergilius
- Toxoplasma gondii
- HSV
- CMV
Causes of Asplenia immune deficiency
- Splenectomy
- Cirrhosis
Asplenia immune deficiency caused by
Reduced properdin so suboptimal opsonization
Low levels of circulating IgM
Infectious etiologies of Asplenia immune deficiency
Encapsulated organisms
Infectious agents of Asplenia immune deficiency
- Strep pneumo
- H. influenzae
- N. meningiditis
- Captocytophaga
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C.
E. coli
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B. Pseudomonas
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E. Staph aureus
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- Fusarium spp.
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D. Chronic granulomatous disease
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B. immunoglobulin levels
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C.
Respiratory infection
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A. Sever combined immunodeficiency
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D. Staphylococcus aureus
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C. Neisseria meningiditis
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D. Varicella zoster
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cell mediated 200

B. respiratory infections with encapsulated organisms
Functions of the neutrophil

Who has low or dysfunctional neutrophils?

Common syndromes associated with neutropenia

Things to remember considering neutropenia

How do we protect neutropenic patients?

Bottom-line of neutropenia

Initial management of fever and neutropenia

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Cell-mediated immunity

Who has dysfunctional cell-mediated immunity

What are the common syndromes associated with impaired cell-mediated immunity?

Common bacterial organisms associated with bacteria
- Listeria moncytogenes
- Nocardia spp.
Common bacterial organisms associated with viruses
- Herpes viruses
- CMV
- Hep B and C
Common bacterial organisms associated with parasites
Toxoplasma gondii
Common bacterial organisms associated with fungus
- Histoplasma capsulatum
- Coccidioides spp.
- Cryptococcus spp.
- Aspergillus spp,
- Pneumocystis jirovecii
Common bacterial organisms associated with mycobacteria
- mycobacterium tuberculosis
- nontuberculous mycobacterium
How do we protect patients with dysfunctional cell-mediated immunity

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Timeline of Hematopoietic Stem Cell Transplantation

Timeline of Hematopoietic Solid Organ Transplantation
