Bacterial, viral and fungal infections in primary immunodeficiency patients

REVIEW ARTICLE

Bacterial, viral and fungal infections in primary immunodeficiency patients

Piotr Naporowski 1 , Danuta Witkowska 1 , Aleksandra Lewandowicz-Uszyńska 2 , Andrzej Gamian 1

1. Laboratorium Mikrobiologii Lekarskiej, Instytut Immunologii i Terapii Doświadczalnej PAN im. L. Hirszfelda we Wrocławiu,
2. III Katedra i Klinika Pediatrii, Immunologii i Reumatologii Wieku Rozwojowego, Uniwersytet Medyczny we Wrocławiu, Oddział Immunologii Klinicznej i Pediatrii, Wojewódzki Szpital Specjalistyczny im. J. Gromkowskiego we Wrocławiu,

Published: 2018-07-06
DOI: 10.5604/01.3001.0012.1734
GICID: 01.3001.0012.1734
Available language versions: en pl
Issue: Postepy Hig Med Dosw 2018; 72 : 557-572

 

Abstract

Primary immunodeficiency diseases (PIDs) are genetic based disorders which lead to the dysfunction of the immune system. There are persistent and recurrent infections within PID patient due to cellular and humoral immunity impairment. The most common infections are caused by Salmonella Enteritidis, Shigella flexneri, Mycobacterium avium complex, Toxoplasma gondii, CMV, Candida albicans, Cryptococcus neoformans or Pneumocystis jiroveci. These infections have a severe course of disease with limited treatment in a conventional way. Full patient recovery after intensive and long-term therapy is often impossible. Viral infections in PID patients are equally frequent. The incidences of Herpesviridae and HCV infections are the same for PID patients and healthy people. However, the infections may have worse course of disease and leave more destruction in the body. Enteroviral infections occur despite the antibodies supplementation; they spread spontaneously throughout the body, also affecting the central nervous system. Skin, nails and mucous membranes infections are equally persistent problems caused by fungi, mainly Candida genus. Infections with these pathogens are often accompanied by hormonal disorders and immunosuppressive therapy. Sepsis and mixed infections are definitely the most dangerous for patients with infections. Infections occur most often in the first years of the child’s life, when the body has not developed yet a fully functioning immunity system. The diagnosis of PNO in infants may be difficult due to the presence of antibodies from mother and the similarity of the symptoms of infectious diseases and common infections.

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