Sepsis in the Severely Immunocompromised Patient

Andre C. Kalil, Steven M. Opal

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations

Abstract

The prevention and treatment of sepsis in the immunocompromised host present a challenging array of diagnostic and management issues. The neutropenic patient has a primary defect in innate immune responses and is susceptible to conventional and opportunistic pathogens. The solid organ transplant patient has a primary defect in adaptive immunity and is susceptible to a myriad of pathogens that require an effective cellular immune response. Risk for infections in organ transplant recipients is further complicated by mechanical, vascular, and rejection of the transplanted organ itself. The immune suppressed state can modify the cardinal signs of inflammation, making accurate and rapid diagnosis of infection and sepsis difficult. Empiric antimicrobial agents can be lifesaving in these patients, but managing therapy in an era of progressive antibiotic resistance has become a real issue. This review discusses the challenges faced when treating severe infections in these high-risk patients.

Original languageEnglish (US)
JournalCurrent Infectious Disease Reports
Volume17
Issue number6
DOIs
StatePublished - Jun 1 2015

Keywords

  • Immunocompromised host
  • Neutropenia
  • Neutropenic fever
  • Sepsis
  • Septic shock
  • Solid organ transplant infections

ASJC Scopus subject areas

  • Infectious Diseases

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