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Chapter 1 : Overview of Infections in the Immunocompromised Host

Authors: Lesia K. Dropulic1, Howard M. Lederman2
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Affiliations: 1: The National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of Intramural Research, Bethesda, MD 20892; 2: Departments of Pediatrics, Medicine, and Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287
Content Type: Monograph
Publication Year: 2016

Category: Clinical Microbiology

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Abstract:

Host defense from infection depends upon a complex, integrated system of physical barriers (e.g., skin, stomach acid, and mucociliary clearance), innate immunity (e.g., phagocytic cells, natural killer cells, complement), and adaptive immunity (B and T lymphocytes). An individual may have deficiencies of one or more components of host defense, but no individual is defenseless. Because each functional compartment of the immune system plays a specialized role in host defense, defects in specific functions lead to increased susceptibility to specific pathogens. The key to understanding the susceptibility of a particular patient is to understand the specific host defense defects of that patient. This article will briefly review the components of host defense and the types of infections that are most likely to occur with specific defects in those defense mechanisms. Following that will be descriptions of the infections that occur in patients with a variety of primary and secondary immune deficiency disorders, with the intent of providing illustrative examples.

Citation: Dropulic L, Lederman H. 2016. Overview of Infections in the Immunocompromised Host, p 3-50. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0026-2016
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Overview of Infections in the Immunocompromised Host
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Citation: Dropulic L, Lederman H. 2016. Overview of Infections in the Immunocompromised Host, p 3-50. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0026-2016
/content/10.1128/9781555819040.chap1.fig1-1
Figure 1

Timeline of infections after solid organ transplantation. Alterations in the timeline occur as a result of antimicrobial prophylaxis or in the presence of excessive immunosuppression or intense epidemiologic exposure to a potential pathogen. HSV, herpes simplex virus; EBV, Epstein-Barr virus; VZV, varicella-zoster virus; RSV, respiratory syncytial virus.

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10.1128/9781555819040/fig1-1.gif
Image of Figure 1
Figure 1

Timeline of infections after solid organ transplantation. Alterations in the timeline occur as a result of antimicrobial prophylaxis or in the presence of excessive immunosuppression or intense epidemiologic exposure to a potential pathogen. HSV, herpes simplex virus; EBV, Epstein-Barr virus; VZV, varicella-zoster virus; RSV, respiratory syncytial virus.

Citation: Dropulic L, Lederman H. 2016. Overview of Infections in the Immunocompromised Host, p 3-50. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0026-2016
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Figure 2

Timeline of infections after autologous hematopoietic cell transplantation.

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10.1128/9781555819040/fig1-2.gif
Image of Figure 2
Figure 2

Timeline of infections after autologous hematopoietic cell transplantation.

Citation: Dropulic L, Lederman H. 2016. Overview of Infections in the Immunocompromised Host, p 3-50. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0026-2016
Permissions and Reprints Request Permissions
Download as Powerpoint
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Figure 3

Timeline of opportunistic infections after allogeneic hematopoietic cell transplantation. PTLD, posttransplant lymphoproliferative disease; TB, tuberculosis; NTM, nontuberculous mycobacteria; GVHD, graft-versus-host disease; RES, reticuloendothelial system.

10.1128/9781555819040/fig1-3_thmb.gif
10.1128/9781555819040/fig1-3.gif
Image of Figure 3
Figure 3

Timeline of opportunistic infections after allogeneic hematopoietic cell transplantation. PTLD, posttransplant lymphoproliferative disease; TB, tuberculosis; NTM, nontuberculous mycobacteria; GVHD, graft-versus-host disease; RES, reticuloendothelial system.

Citation: Dropulic L, Lederman H. 2016. Overview of Infections in the Immunocompromised Host, p 3-50. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0026-2016
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