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Clinics in Chest Medicine Jun 2023Immunocompromised hosts, which encompass a diverse population of persons with malignancies, human immunodeficiency virus disease, solid organ, and hematologic... (Review)
Review
Immunocompromised hosts, which encompass a diverse population of persons with malignancies, human immunodeficiency virus disease, solid organ, and hematologic transplants, autoimmune diseases, and primary immunodeficiencies, bear a significant burden of the morbidity and mortality due to coronavirus disease-2019 (COVID-19). Immunocompromised patients who develop COVID-19 have a more severe illness, higher hospitalization rates, and higher mortality rates than immunocompetent patients. There are no well-defined treatment strategies that are specific to immunocompromised patients and vaccines, monoclonal antibodies, and convalescent plasma are variably effective. This review focuses on the specific impact of COVID-19 in immunocompromised patients and the gaps in knowledge that require further study.
Topics: Humans; COVID-19; SARS-CoV-2; COVID-19 Serotherapy; Immunocompromised Host
PubMed: 37085228
DOI: 10.1016/j.ccm.2022.11.012 -
Intensive Care Medicine Feb 2020An increasing number of critically ill patients are immunocompromised. Acute hypoxemic respiratory failure (ARF), chiefly due to pulmonary infection, is the leading... (Review)
Review
An increasing number of critically ill patients are immunocompromised. Acute hypoxemic respiratory failure (ARF), chiefly due to pulmonary infection, is the leading reason for ICU admission. Identifying the cause of ARF increases the chances of survival, but may be extremely challenging, as the underlying disease, treatments, and infection combine to create complex clinical pictures. In addition, there may be more than one infectious agent, and the pulmonary manifestations may be related to both infectious and non-infectious insults. Clinically or microbiologically documented bacterial pneumonia accounts for one-third of cases of ARF in immunocompromised patients. Early antibiotic therapy is recommended but decreases the chances of identifying the causative organism(s) to about 50%. Viruses are the second most common cause of severe respiratory infections. Positive tests for a virus in respiratory samples do not necessarily indicate a role for the virus in the current acute illness. Invasive fungal infections (Aspergillus, Mucorales, and Pneumocystis jirovecii) account for about 15% of severe respiratory infections, whereas parasites rarely cause severe acute infections in immunocompromised patients. This review focuses on the diagnosis of severe respiratory infections in immunocompromised patients. Special attention is given to newly validated diagnostic tests designed to be used on non-invasive samples or bronchoalveolar lavage fluid and capable of increasing the likelihood of an early etiological diagnosis.
Topics: Humans; Immunocompromised Host; Intensive Care Units; Invasive Fungal Infections; Parasitic Diseases; Pneumonia, Bacterial; Respiratory Insufficiency; Respiratory Tract Infections
PubMed: 32034433
DOI: 10.1007/s00134-019-05906-5 -
Infectious Disease Clinics of North... Mar 2024Immunocompromised hosts, which encompass a diverse population of persons with malignancies, human immunodeficiency virus disease, solid organ, and hematologic... (Review)
Review
Immunocompromised hosts, which encompass a diverse population of persons with malignancies, human immunodeficiency virus disease, solid organ, and hematologic transplants, autoimmune diseases, and primary immunodeficiencies, bear a significant burden of the morbidity and mortality due to coronavirus disease-2019 (COVID-19). Immunocompromised patients who develop COVID-19 have a more severe illness, higher hospitalization rates, and higher mortality rates than immunocompetent patients. There are no well-defined treatment strategies that are specific to immunocompromised patients and vaccines, monoclonal antibodies, and convalescent plasma are variably effective. This review focuses on the specific impact of COVID-19 in immunocompromised patients and the gaps in knowledge that require further study.
Topics: Humans; COVID-19; SARS-CoV-2; COVID-19 Serotherapy; Immunocompromised Host; Neoplasms
PubMed: 38280765
DOI: 10.1016/j.idc.2023.12.007 -
Seminars in Roentgenology Jan 2022Pneumonia in the immunocompromised host can be devastating and can result from both common and opportunistic organisms. This paper examines the imaging findings in...
Pneumonia in the immunocompromised host can be devastating and can result from both common and opportunistic organisms. This paper examines the imaging findings in mostly opportunistic organisms which cause pneumonia in the immunocompromised host. Some organisms, such as tuberculosis, non-tuberculous mycobacteria, and influenza will also be discussed because although they are not specifically opportunistic, they can result in extensive and devastating disease in immunocompromised patients. It is important for the radiologist to recognize unique imaging findings in pneumonia in the immunocompromised patient and raise the possibility of certain organisms to direct appropriate therapy.
Topics: Humans; Immunocompromised Host; Pneumonia
PubMed: 35090713
DOI: 10.1053/j.ro.2021.10.009 -
Radiologic Clinics of North America Sep 2011Pneumonia is an infection of the lung parenchyma caused by a wide variety of organisms in pediatric patients. The role of imaging is to detect the presence of pneumonia,... (Review)
Review
Pneumonia is an infection of the lung parenchyma caused by a wide variety of organisms in pediatric patients. The role of imaging is to detect the presence of pneumonia, and determine its location and extent, exclude other thoracic causes of respiratory symptoms, and show complications such as effusion/empyema and suppurative lung changes. The overarching goal of this article is to review cause, role of imaging, imaging techniques, and the spectrum of acute and chronic pneumonias in children. Pneumonia in the neonate and immunocompromised host is also discussed.
Topics: Adolescent; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Immunocompromised Host; Infant; Infant, Newborn; Lung; Male; Pneumonia; Tomography, X-Ray Computed; Ultrasonography
PubMed: 21889014
DOI: 10.1016/j.rcl.2011.06.007 -
Journal of Leukocyte Biology Jul 2022β- and γ-herpesviruses persistently infect most of the world population, largely without clinical manifestations. However, in immunosuppressive settings like... (Review)
Review
β- and γ-herpesviruses persistently infect most of the world population, largely without clinical manifestations. However, in immunosuppressive settings like transplantation, these viruses are often jointly reactivated, associating with graft dysfunction/rejection, HCMV disease, and lymphoproliferation. In HIV/AIDS, direct interaction mechanisms have been described for EBV and KSHV in primary effusion lymphoma, demonstrating that the cooperation between both viruses enhances lymphomagenesis. Here, we discuss the clinical evidence supporting that the simultaneous reactivation of these viruses increases the probability of mutual interactions, also providing a conceptual framework explaining how one virus can influence another. Specifically, we propose mechanisms of indirect communication through immune soluble mediators, mainly cytokines, chemokines, and IFN regulatory molecules, based on common features of their infectious cycles and the convergent need on immunomodulatory mechanisms. This latter point should be experimentally addressed in feature research.
Topics: Herpesviridae; Herpesvirus 8, Human; Immunocompromised Host
PubMed: 35060655
DOI: 10.1002/JLB.4MR1221-452R -
Emergency Medicine Clinics of North... Nov 1998A broad classification of immune defects provides a framework for the approach to fever in the immunocompromised host. Practical, historical, and physical examination... (Review)
Review
A broad classification of immune defects provides a framework for the approach to fever in the immunocompromised host. Practical, historical, and physical examination findings are reviewed, and common clinical scenarios are highlighted. A general initial work-up and treatment plan are outlined.
Topics: Anti-Bacterial Agents; Diagnosis, Differential; Emergency Treatment; Fever; Humans; Immunocompromised Host; Medical History Taking; Physical Examination
PubMed: 9889739
DOI: 10.1016/s0733-8627(05)70032-8 -
Medical Mycology Jun 2019The use of cytotoxic chemotherapy in the treatment of malignant and inflammatory disorders is beset by considerable adverse effects related to nonspecific cytotoxicity.... (Review)
Review
The use of cytotoxic chemotherapy in the treatment of malignant and inflammatory disorders is beset by considerable adverse effects related to nonspecific cytotoxicity. Accordingly, a mechanistic approach to therapeutics has evolved in recent times with small molecular inhibitors of intracellular signaling pathways involved in disease pathogenesis being developed for clinical use, some with unparalleled efficacy and tolerability. Nevertheless, there are emerging concerns regarding an association with certain small molecular inhibitors and opportunistic infections, including invasive fungal diseases. This is perhaps unsurprising, given that the molecular targets of such agents play fundamental and multifaceted roles in orchestrating innate and adaptive immune responses. Nevertheless, some small molecular inhibitors appear to possess intrinsic antifungal activity and may therefore represent novel therapeutic options in future. This is particularly important given that antifungal resistance is a significant, emerging concern. This paper is a comprehensive review of the state-of-the-art in the molecular immunology to fungal pathogens as applied to existing and emerging small molecular inhibitors.
Topics: Antifungal Agents; Drug Resistance, Fungal; Humans; Immunocompromised Host; Immunotherapy; Invasive Fungal Infections
PubMed: 31292657
DOI: 10.1093/mmy/myy136 -
Pediatrics in Review Dec 1996
Review
Topics: Child; Humans; Immunocompromised Host; Immunologic Deficiency Syndromes; Immunologic Tests; Infant; Infant, Newborn
PubMed: 8973124
DOI: No ID Found -
Indian Journal of Dermatology,... 2018Herpes zoster is a major health burden that can affect individuals of any age. It is seen more commonly among individuals aged ≥50 years, those with immunocompromised... (Review)
Review
Herpes zoster is a major health burden that can affect individuals of any age. It is seen more commonly among individuals aged ≥50 years, those with immunocompromised status, and those on immunosuppressant drugs. It is caused by a reactivation of varicella zoster virus infection. Cell-mediated immunity plays a role in this reactivation. Fever, pain, and itch are common symptoms before the onset of rash. Post-herpetic neuralgia is the most common complication associated with herpes zoster. Risk factors and complications associated with herpes zoster depend on the age, immune status, and the time of initializing treatment. Routine vaccination for individuals over 60 years has shown considerable effect in terms of reducing the incidence of herpes zoster and post-herpetic neuralgia. Treatment with antiviral drugs and analgesics within 72 hours of rash onset has been shown to reduce severity and complications associated with herpes zoster and post-herpetic neuralgia. This study mainly focuses on herpes zoster using articles and reviews from PubMed, Embase, Cochrane library, and a manual search from Google Scholar. We cover the incidence of herpes zoster, gender distribution, seasonal and regional distribution of herpes zoster, incidence of herpes zoster among immunocompromised individuals, incidence of post-herpetic neuralgia following a zoster infection, complications, management, and prevention of herpes zoster and post-herpetic neuralgia.
Topics: Adrenal Cortex Hormones; Antiviral Agents; Electric Stimulation Therapy; Herpes Zoster; Humans; Immunocompromised Host; Incidence; Neuralgia, Postherpetic; Risk Factors; Sex Factors; Treatment Outcome
PubMed: 29516900
DOI: 10.4103/ijdvl.IJDVL_1021_16