HEMATOLOGY, ONCOLOGY, ALLERGY,AND IMMUNOLOGY
■ Chronic mucocutaneous candiasis
■ Recurrent candida infections
■ Severe combined immunodeficiency syndrome
■ Recurrent viral, bacterial, fungal, and protozoan infections
■ Wiskott-Aldrich syndrome
■ Recurrent pyogenic infections, eczema, thrombocytopenia.
■ Hodgkin disease
■ Impaired delayed type hypersensitivity recall to antigens
■ AIDS
■ Lymphopenia and depleted CD4 T cell
■ Opportunistic infections with PCP, Cryptococcus meningitis, CNS toxo-
plasmosis,Mycobacterium aviumcomplex, tuberculosis, candiasis, CMV
■ Please see section on AIDS for further discussion.
■ Treatment of transplant rejection
■ Immunosuppressive therapies
Neutropenia
■ Absolute neutrophil count <500 cells/μL
■ Susceptible to pseudomonas and staphylococci infection
■ May have bacteremia, pneumonia, perirectal/perineal infections
Medical Therapies
■ Various medications may cause reduced resistance to infections.
■ Glucocorticoids, methotrexate, azathioprine, mycophenolate mofetil,
cyclophosphamide, tumor necrosis factors inhibitors, chemotherapeutic
agents
■ Plasmaphoresis
■ Removal of plasma from the body also removes antibodies, which leaves
the body susceptible to bacterial infection.
■ Radiation
■ May impair production of leukocytes
Diabetes Mellitus
■ Diabetics have a higher incidence of infections.
■ Cystitis, pyelonephritis, candida vulvovaginitis, pneumonia, bronchitis,
bacteremia, lower-extremity infections, surgical wound infections, tuber-
culosis,otitis externa, mucormycosis, Fournier gangrene
■ Mechanisms of increased susceptibility to infection:
■ Impaired neutrophil function
■ Circulatory insufficiency, leading to delayed response to infection
■ Sensory deficits, causing decreased awareness of skin trauma
■ Autonomic dysfunction, causing urinary retention
Patients with cellular immune
dysfunction are susceptible to
intracellular infections
including listeria,
mycobacterium, cryptococcus,
fungi, HSV, CMV, and
Pneumocystis carinii.