Chapter 1 : Overview of Infections in the Immunocompromised Host

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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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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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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
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
Permissions and Reprints Request Permissions
Download as Powerpoint


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