Immunocompromise II

Question 1

Late Component Complement Deficiency (LCCD) results from deficiency of any of the following: C5-C9. What are its characteristics?

Answer 1

• incs risk of meningococcal infx 5000 to 10,000 fold
• age of onset of meningococcal infx is much later in LCCD (17 yo vs 5 yo)
• serogroups causing meningicoccal disease in pts with LCCD are uncommon
• 50% pts with LCCD get recurrent infx
• mortality from meningococcal disease in LCCD is 1/10 of that in general population -vaccination against meningococcus benefits these pts

Question 2

Neutrophil deficits (quantity/quality) result in infx from our own microbiome. What pathogens cause the most common infectious complications from deficits in neutrophils?

Answer 2

• Staphylococci
• gram-negative bacteria
• fungi

Question 3

what is the main complication for neutropoenia versus neutrophil dysfunction?

Answer 3

• neutropoenia: sepsis

- neutrophil dysfunction:localized dysfunction

Question 4

Neutropoenia results in increased risk for infection dur to which two road groups of pathogens?

Answer 4

• microflora

- aspergillus (environmental fungus)

Question 5

What is a complication of chemotherapy-induced neutropoenia?

Answer 5

-Febrile Neutropoenia (FNP)

Question 6

How does chemotherapy impact primary defenses (weaken them)?

Answer 6

• disrupted mucosal barriers: gram negative bacilli cause GI infx
• venous catheters cause skin organisms to enter (gram positive cocci)
• broad spectrum antibiotics –> fungi become more dangerous in later FNP

Question 7

Recovery of neutrophil count can result in what 2 major immune reconstitution syndromes?

Answer 7

• asymptomatic pulmonary infiltrates

- hepatosplenic candidiasis (granulomatous response)

Question 8

What infections are hospitalized patients at greater risk of developing?

Answer 8

• CDAD
• UTI
• bacteroemia (due to venous catheters)
• hospital-acquired MRSA and VRE
• surgical site infections