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Chapter 12. Infections in AIDS Patients and Other Immunocompromised Hosts

George H Karam, MD, FCCP
DOI: 10.1378/critcare.21.12
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Sections

Objectives 
  • Propose an approach to the immunocompromised patient based on identification of defects in three major host defense systems.

  • Review the likely pathogens, their clinical presentations, and therapeutic options in patients with neutropenia.

  • Summarize the various limbs in humoral immunity, with particular attention to the clinical situations of asplenia and splenic dysfunction.

  • Outline the categories and clinical presentations of pathogens likely to be encountered with deficits of cell-mediated immunity.

  • Focus on the broadening number of clinical issues in patients whose cell-mediated immunity defect is on the basis of HIV infection.

Synopsis 

The identification of a defect in neutrophil function, humoral immunity, or cell-mediated immunity allows the clinician to better focus on the most likely pathogens involved in an infectious process. An approach to the immunocompromised patient based on pathogenesis of disease should result in more directed, cost-effective therapy and in improved patient outcome.

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