Acquired immunodeficiency: Difference between revisions

Revision as of 21:26, 15 February 2021

Clinical Manifestations

Immune Defect	Typical Infections	Typical Organisms
cell-mediated (T cells)	persistent viral infections, opportunistic infections, disseminated infections	Pneumocystis jirovecii, Cryptococcus, Herpesviridae
humoural (B cells)	respiratory infections with encapsulated organisms, chronic diarrhea, aseptic meningitis	Haemophilus influenzae, Streptococcus pneumoniae, Giardia lamblia, Campylobacter species, enteroviruses
phagocytic	recurrent abscesses, gingivitis, aphthous ulcers	Staphylococcus aureus, Burkholderia cepacia, Serratia marcescens, Aspergillus species, Nocardia species
monocytic	disseminated infections and multifocal osteomyelitis	non-tuberculous mycobacteria, Salmonella species, Histoplasma capsulatum, Coccidioides immitis
TLR	recurrent meningitis, bacteremia, absence of fever	Streptococcus pneumoniae, Neisseria meningitidis, Staphylococcus aureus, HSV
complement	recurrent bacteremia and meningitis	Neisseria species
T cells and phagocytes	eczema, kyphoscoliosis, pathologic fratures, pulmonary and cutaneous infections, mucocutaneous candidiasis	Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Candida albicans

Differential Diagnosis

Cell-Mediated Immunodeficiency

Humoural Immunodeficiency

Splenectomy and asplenism
Complement deficiency
Common variable immunodeficiency
Rituximab and other anti-CD20 therapy
Multiple myeloma and chronic lymphocytic leukemia

@@ Line 1: / Line 1: @@
-== Differential Diagnosis ==
+== Clinical Manifestations ==
+{| class="wikitable"
+!Immune Defect
+!Typical Infections
+!Typical Organisms
+|-
+|cell-mediated (T cells)
+|persistent viral infections, opportunistic infections, disseminated infections
+|[[Pneumocystis jirovecii]], [[Cryptococcus]], [[Herpesviridae]]
+|-
+|humoural (B cells)
+|respiratory infections with [[Encapsulated bacteria|encapsulated organisms]], [[chronic diarrhea]], [[aseptic meningitis]]
+|[[Haemophilus influenzae]], [[Streptococcus pneumoniae]], [[Giardia lamblia]], [[Campylobacter species]], [[Enterovirus|enteroviruses]]
+|-
+|phagocytic
+|recurrent [[Abscess|abscesses]], [[gingivitis]], [[Aphthous ulcer|aphthous ulcers]]
+|[[Staphylococcus aureus]], [[Burkholderia cepacia]], [[Serratia marcescens]], [[Aspergillus species]], [[Nocardia species]]
+|-
+|monocytic
+|disseminated infections and multifocal [[osteomyelitis]]
+|[[non-tuberculous mycobacteria]], [[Salmonella species]], [[Histoplasma capsulatum]], [[Coccidioides immitis]]
+|-
+|[[Toll-like receptors|TLR]]
+|recurrent [[meningitis]], [[bacteremia]], absence of fever
+|[[Streptococcus pneumoniae]], [[Neisseria meningitidis]], [[Staphylococcus aureus]], [[HSV]]
+|-
+|complement
+|recurrent [[bacteremia]] and [[meningitis]]
+|[[Neisseria species]]
+|-
+|T cells and phagocytes
+|[[eczema]], [[kyphoscoliosis]], pathologic fratures, pulmonary and cutaneous infections, [[mucocutaneous candidiasis]]
+|[[Staphylococcus aureus]], [[Haemophilus influenzae]], [[Streptococcus pneumoniae]], [[Candida albicans]]
+|}
+==Differential Diagnosis==
-=== Cell-Mediated Immunodeficiency ===
+===Cell-Mediated Immunodeficiency===
-* [[Corticosteroids]]
+*[[Corticosteroids]]
-* [[Solid organ transplantation]]
+*[[Solid organ transplantation]]
-* Hematologic malignancy
+*Hematologic malignancy
-** [[Hairy cell leukemia]]
+**[[Hairy cell leukemia]]
-** [[Acute T-cell leukemia]]
+**[[Acute T-cell leukemia]]
-** [[T-cell lymphoma]]
+**[[T-cell lymphoma]]
-* Chemotherapy
+*Chemotherapy
-** [[Fludarabine]]
+**[[Fludarabine]]
-** [[Ibrutinib]]
+**[[Ibrutinib]]
-** [[Alemtuzumab]]
+**[[Alemtuzumab]]
-=== Humoural Immunodeficiency ===
+===Humoural Immunodeficiency===
-* [[Splenectomy]] and [[asplenism]]
+*[[Splenectomy]] and [[asplenism]]
-* [[Complement deficiency]]
+*[[Complement deficiency]]
-* [[Common variable immunodeficiency]]
+*[[Common variable immunodeficiency]]
-* [[Rituximab]] and other anti-CD20 therapy
+*[[Rituximab]] and other anti-CD20 therapy
-* [[Multiple myeloma]] and [[chronic lymphocytic leukemia]]
+*[[Multiple myeloma]] and [[chronic lymphocytic leukemia]]
-=== Phagocyte Immunodeficiency ===
+===Phagocyte Immunodeficiency===
-* [[Corticosteroids]]
+*[[Corticosteroids]]
-* [[Solid organ transplantation]]
+*[[Solid organ transplantation]]
-* [[Neutropenia]]
+*[[Neutropenia]]
-* [[Myelodysplastic syndrome]]
+*[[Myelodysplastic syndrome]]
-* [[Acute myelogenous leukemia]]
+*[[Acute myelogenous leukemia]]
-* [[Allogeneic hematopoietic stem cell transplantation]]
+*[[Allogeneic hematopoietic stem cell transplantation]]