10.1 Immunocompromised Host Flashcards
(22 cards)
How can a an underlying immune deficiency be suggested clinically?
SPUR
What does the ‘S’ in SPUR stand for?
Severe- the diseases a patient is getting are life-threatening or require hospitalisation
What does the ‘P’ in SPUR stand for?
Persistence- the infection does not go away despite treatment
What does the ‘U’ in SPUR stand for?
Unusual- the infections a patient is getting are from abnormal microorganisms or are effecting an abnormal site
What does the ‘R’ in SPUR stand for?
Recurrent- the infections keep recurring in the same patient
What is primary immunodeficiency?
Due to an intrinsic defect such as a gene disorder or polymorphism
How are primary ID classified?
Classified by the defected immune component eg. B cells
What is common variable immunodeficiency?
Inability of B cells to mature into plasma cells
How do B cell ID present?
Recurrent respiratory bacterial infections
GI complications
Increased autoimmune diseases
How are B cell ID managed?
Prompt/prophylactic antibiotics
Manage respiratory function
Immunoglobulin replacement therapy
What is chronic granulomatous disease (CGD)?
Lack of respiratory burst from phagocytes so engulfed pathogens cannot be killed
What is leukocyte adhesion deficiency (LAD)?
Lack of CD18 protein on phagocytes so they cannot adhere to the epithelium or migrate to the site of infection
How do phagocyte IDs present?
Prolonged and recurrent infections
How can phagocyte ID be managed?
Prophylactic antibiotics and antifungals
Surgery
Steroids
Stem cell transportation
What is Severe Combined Immunodeficiency (SCID)?
A defect in stem cells or defective T cell development to mean leukocyte numbers are very low.
How will a patient present if they have a complement deficiency in C5-C9?
Recurrent Neisserial infections
What is secondary ID?
A decrease in production of immune components due to eg. malnutrition, liver disease, infections
Why is the spleen important in immune defence?
It removes bacteria from the blood
It produces antibodies
Contains macrophages
What type of bacteria is a patient with no spleen more at risk of becoming infected by?
Encapsulated bacteria
How can chemotherapy affect immune defences?
Induce neutropenia
Damage mucosal barriers
Give three examples of tests that can be done if ID is suspected
Full blood count
Measure IgG, IgA, IgM, IgE
Measure antibody in response
IgG levels to specific vaccines
What is an immunocompromised host?
State in which the immune system cannot respond to infectious organisms.
