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Principles of Adult Surgical Critical Care pp 393–405Cite as

Immunocompromised Patients

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Abstract

In this chapter, we will review the principles of caring for an immunocompromised patient in the surgical intensive care unit (ICU), focusing on those in which infection is suspected. We will review in detail the management of patients who have undergone solid organ transplantation (SOT), stem cell transplantation (SCT), chemotherapy, radiation, chronic corticosteroid therapy, and tumor necrosis factor-alpha (TNF-α (alpha)) inhibitor therapy and those with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), chronic hepatitis B virus (HBV), or chronic hepatitis C virus (HCV) infection. We will review risk factors for viral, bacterial, and fungal infections in these patients, as well as an approach to their initial diagnostic evaluation and treatment.

In general, clinicians should maintain a high degree of suspicion for infection in these patient populations, as such patients often will not present with classic symptoms due to their inability to mount an inflammatory response. Because infections may remain occult for a more prolonged period of time, and infection can progress rapidly in these patients, when an immunocompromised patient is admitted to the surgical ICU, aggressive diagnostic and therapeutic measures may be necessary.

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References

  1. Fishman JA. Infection in solid-organ transplant recipients. N Engl J Med. 2007;357(25):2601–14.

    CAS  PubMed  Google Scholar 

  2. Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006;34(6):1589–96.

    PubMed  Google Scholar 

  3. Barie PS, Hydo LJ, Shou J, Larone DH, Eachempati SR. Influence of antibiotic therapy on mortality of critical surgical illness caused or complicated by infection. Surg Infect (Larchmt). 2005;6(1):41–54.

    PubMed  Google Scholar 

  4. Everhart JE, Wei Y, Eng H, Charlton MR, Persing DH, Wiesner RH, et al. Recurrent and new hepatitis C virus infection after liver transplantation. Hepatology. 1999;29(4):1220–6.

    CAS  PubMed  Google Scholar 

  5. Seehofer D, Berg T. Prevention of hepatitis B recurrence after liver transplantation. Transplantation. 2005;80(1 Suppl):S120–4.

    PubMed  Google Scholar 

  6. Scoggin CH, Call NB. Acute respiratory failure due to disseminated strongyloidiasis in a renal transplant recipient. Ann Intern Med. 1977;87(4):456–8.

    CAS  PubMed  Google Scholar 

  7. Luong ML, Chaparro C, Stephenson A, Rotstein C, Singer LG, Waters V, et al. Pretransplant Aspergillus colonization of cystic fibrosis patients and the incidence of post-lung transplant invasive aspergillosis. Transplantation. 2014;97(3):351–7.

    CAS  PubMed  Google Scholar 

  8. Mattner F, Fischer S, Weissbrodt H, Chaberny IF, Sohr D, Gottlieb J, et al. Post-operative nosocomial infections after lung and heart transplantation. J Heart Lung Transplant. 2007;26(3):241–9.

    PubMed  Google Scholar 

  9. Subramanian AK, Morris MI, Practice ASTIDCo. Mycobacterium tuberculosis infections in solid organ transplantation. Am J Transplant. 2013;13 Suppl 4:68–76.

    CAS  PubMed  Google Scholar 

  10. Kransdorf EP, Zakowski PC, Kobashigawa JA. Chagas disease in solid organ and heart transplantation. Curr Opin Infect Dis. 2014;27(5):418–24.

    PubMed  Google Scholar 

  11. Angelis M, Cooper JT, Freeman RB. Impact of donor infections on outcome of orthotopic liver transplantation. Liver Transpl. 2003;9(5):451–62.

    PubMed  Google Scholar 

  12. Delmonico FL. Cadaver donor screening for infectious agents in solid organ transplantation. Clin Infect Dis. 2000;31(3):781–6.

    CAS  PubMed  Google Scholar 

  13. Freeman RB, Giatras I, Falagas ME, Supran S, O'Connor K, Bradley J, et al. Outcome of transplantation of organs procured from bacteremic donors. Transplantation. 1999;68(8):1107–11.

    CAS  PubMed  Google Scholar 

  14. Fischer SA, Graham MB, Kuehnert MJ, Kotton CN, Srinivasan A, Marty FM, et al. Transmission of lymphocytic choriomeningitis virus by organ transplantation. N Engl J Med. 2006;354(21):2235–49.

    CAS  PubMed  Google Scholar 

  15. Iwamoto M, Jernigan DB, Guasch A, Trepka MJ, Blackmore CG, Hellinger WC, et al. Transmission of West Nile virus from an organ donor to four transplant recipients. N Engl J Med. 2003;348(22):2196–203.

    PubMed  Google Scholar 

  16. Srinivasan A, Burton EC, Kuehnert MJ, Rupprecht C, Sutker WL, Ksiazek TG, et al. Transmission of rabies virus from an organ donor to four transplant recipients. N Engl J Med. 2005;352(11):1103–11.

    CAS  PubMed  Google Scholar 

  17. Centers for Disease C, Prevention. Chagas disease after organ transplantation – United States, 2001. MMWR Morb Mortal Wkly Rep. 2002;51(10):210–2.

    Google Scholar 

  18. Abanyie FA, Gray EB, Delli Carpini KW, Yanofsky A, McAuliffe I, Rana M, et al. Donor-derived Strongyloides stercoralis infection in solid organ transplant recipients in the United States, 2009–2013. Am J Transplant. 2015;15(5):1369–75.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Remeijer L, Maertzdorf J, Doornenbal P, Verjans GM, Osterhaus AD. Herpes simplex virus 1 transmission through corneal transplantation. Lancet. 2001;357(9254):442.

    CAS  PubMed  Google Scholar 

  20. Paya C, Humar A, Dominguez E, Washburn K, Blumberg E, Alexander B, et al. Efficacy and safety of valganciclovir vs. oral ganciclovir for prevention of cytomegalovirus disease in solid organ transplant recipients. Am J Transplant. 2004;4(4):611–20.

    CAS  PubMed  Google Scholar 

  21. McKinnell JA, Cannella AP, Kunz DF, Hook 3rd EW, Moser SA, Miller LG, et al. Pneumocystis pneumonia in hospitalized patients: a detailed examination of symptoms, management, and outcomes in human immunodeficiency virus (HIV)-infected and HIV-uninfected persons. Transpl Infect Dis. 2012;14(5):510–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Kovacs JA, Hiemenz JW, Macher AM, Stover D, Murray HW, Shelhamer J, et al. Pneumocystis carinii pneumonia: a comparison between patients with the acquired immunodeficiency syndrome and patients with other immunodeficiencies. Ann Intern Med. 1984;100(5):663–71.

    CAS  PubMed  Google Scholar 

  23. Fujii T, Nakamura T, Iwamoto A. Pneumocystis pneumonia in patients with HIV infection: clinical manifestations, laboratory findings, and radiological features. J Infect Chemother. 2007;13(1):1–7.

    PubMed  Google Scholar 

  24. Beam E, Razonable RR. Cytomegalovirus in solid organ transplantation: epidemiology, prevention, and treatment. Curr Infect Dis Rep. 2012;14(6):633–41.

    PubMed  Google Scholar 

  25. Bate SL, Dollard SC, Cannon MJ. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988-2004. Clin Infect Dis. 2010;50(11):1439–47.

    PubMed  Google Scholar 

  26. Razonable R. Direct and indirect effects of cytomegalovirus: can we prevent them? Enferm Infecc Microbiol Clin. 2010;28(1):1–5.

    PubMed  Google Scholar 

  27. Manuel O, Pang XL, Humar A, Kumar D, Doucette K, Preiksaitis JK. An assessment of donor-to-recipient transmission patterns of human cytomegalovirus by analysis of viral genomic variants. J Infect Dis. 2009;199(11):1621–8.

    CAS  PubMed  Google Scholar 

  28. Pappas PG, Alexander BD, Andes DR, Hadley S, Kauffman CA, Freifeld A, et al. Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Clin Infect Dis. 2010;50(8):1101–11.

    PubMed  Google Scholar 

  29. Pfeiffer CD, Fine JP, Safdar N. Diagnosis of invasive aspergillosis using a galactomannan assay: a meta-analysis. Clin Infect Dis. 2006;42(10):1417–27.

    CAS  PubMed  Google Scholar 

  30. Alexander BD, Smith PB, Davis RD, Perfect JR, Reller LB. The (1,3){beta}-D-glucan test as an aid to early diagnosis of invasive fungal infections following lung transplantation. J Clin Microbiol. 2010;48(11):4083–8.

    PubMed  PubMed Central  Google Scholar 

  31. Zou W. Immunosuppressive networks in the tumour environment and their therapeutic relevance. Nat Rev Cancer. 2005;5(4):263–74.

    CAS  PubMed  Google Scholar 

  32. Tisch M, Heimlich F, Daniel V, Opelz G, Maier H. Cellular immune defect caused by postsurgical radiation therapy in patients with head and neck cancer. Otolaryngol Head Neck Surg. 1998;119(4):412–7.

    CAS  PubMed  Google Scholar 

  33. Talmage DW. Effect of ionizing radiation on resistance and infection. Annu Rev Microbiol. 1955;9:335–46.

    CAS  PubMed  Google Scholar 

  34. Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011;52(4):e56–93.

    PubMed  Google Scholar 

  35. Klastersky J. Management of fever in neutropenic patients with different risks of complications. Clin Infect Dis. 2004;39 Suppl 1:S32–7.

    PubMed  Google Scholar 

  36. Zinner SH. Changing epidemiology of infections in patients with neutropenia and cancer: emphasis on gram-positive and resistant bacteria. Clin Infect Dis. 1999;29(3):490–4.

    CAS  PubMed  Google Scholar 

  37. Cattaneo C, Quaresmini G, Casari S, Capucci MA, Micheletti M, Borlenghi E, et al. Recent changes in bacterial epidemiology and the emergence of fluoroquinolone-resistant Escherichia coli among patients with haematological malignancies: results of a prospective study on 823 patients at a single institution. J Antimicrob Chemother. 2008;61(3):721–8.

    CAS  PubMed  Google Scholar 

  38. Oliveira AL, de Souza M, Carvalho-Dias VM, Ruiz MA, Silla L, Tanaka PY, et al. Epidemiology of bacteremia and factors associated with multi-drug-resistant gram-negative bacteremia in hematopoietic stem cell transplant recipients. Bone Marrow Transplant. 2007;39(12):775–81.

    CAS  PubMed  Google Scholar 

  39. Ramphal R. Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the currently isolated pathogens. Clin Infect Dis. 2004;39 Suppl 1:S25–31.

    PubMed  Google Scholar 

  40. Gerson SL, Talbot GH, Hurwitz S, Strom BL, Lusk EJ, Cassileth PA. Prolonged granulocytopenia: the major risk factor for invasive pulmonary aspergillosis in patients with acute leukemia. Ann Intern Med. 1984;100(3):345–51.

    CAS  PubMed  Google Scholar 

  41. Portugal RD, Garnica M, Nucci M. Index to predict invasive mold infection in high-risk neutropenic patients based on the area over the neutrophil curve. J Clin Oncol. 2009;27(23):3849–54.

    PubMed  Google Scholar 

  42. Odabasi Z, Mattiuzzi G, Estey E, Kantarjian H, Saeki F, Ridge RJ, et al. Beta-D-glucan as a diagnostic adjunct for invasive fungal infections: validation, cutoff development, and performance in patients with acute myelogenous leukemia and myelodysplastic syndrome. Clin Infect Dis. 2004;39(2):199–205.

    CAS  PubMed  Google Scholar 

  43. Ostrosky-Zeichner L, Alexander BD, Kett DH, Vazquez J, Pappas PG, Saeki F, et al. Multicenter clinical evaluation of the (1-->3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans. Clin Infect Dis. 2005;41(5):654–9.

    CAS  PubMed  Google Scholar 

  44. Wheat LJ. Rapid diagnosis of invasive aspergillosis by antigen detection. Transpl Infect Dis. 2003;5(4):158–66.

    CAS  PubMed  Google Scholar 

  45. Zuckermann J, Moreira LB, Stoll P, Moreira LM, Kuchenbecker RS, Polanczyk CA. Compliance with a critical pathway for the management of febrile neutropenia and impact on clinical outcomes. Ann Hematol. 2008;87(2):139–45.

    CAS  PubMed  Google Scholar 

  46. Pizzo PA, Robichaud KJ, Gill FA, Witebsky FG. Empiric antibiotic and antifungal therapy for cancer patients with prolonged fever and granulocytopenia. Am J Med. 1982;72(1):101–11.

    CAS  PubMed  Google Scholar 

  47. Schimpff SC. Empiric antibiotic therapy for granulocytopenic cancer patients. Am J Med. 1986;80(5C):13–20.

    CAS  PubMed  Google Scholar 

  48. DeGregorio MW, Lee WM, Linker CA, Jacobs RA, Ries CA. Fungal infections in patients with acute leukemia. Am J Med. 1982;73(4):543–8.

    CAS  PubMed  Google Scholar 

  49. Wingard JR, Hsu J, Hiemenz JW. Hematopoietic stem cell transplantation: an overview of infection risks and epidemiology. Infect Dis Clin North Am. 2010;24(2):257–72.

    PubMed  Google Scholar 

  50. Wingard JR, Hiemenz JW, Jantz MA. How I manage pulmonary nodular lesions and nodular infiltrates in patients with hematologic malignancies or undergoing hematopoietic cell transplantation. Blood. 2012;120(9):1791–800.

    CAS  PubMed  Google Scholar 

  51. De Castro N, Neuville S, Sarfati C, Ribaud P, Derouin F, Gluckman E, et al. Occurrence of Pneumocystis jirovecii pneumonia after allogeneic stem cell transplantation: a 6-year retrospective study. Bone Marrow Transplant. 2005;36(10):879–83.

    PubMed  Google Scholar 

  52. La Rosa AM, Champlin RE, Mirza N, Gajewski J, Giralt S, Rolston KV, et al. Adenovirus infections in adult recipients of blood and marrow transplants. Clin Infect Dis. 2001;32(6):871–6.

    PubMed  Google Scholar 

  53. Erard V, Storer B, Corey L, Nollkamper J, Huang ML, Limaye A, et al. BK virus infection in hematopoietic stem cell transplant recipients: frequency, risk factors, and association with postengraftment hemorrhagic cystitis. Clin Infect Dis. 2004;39(12):1861–5.

    PubMed  Google Scholar 

  54. Youssef S, Rodriguez G, Rolston KV, Champlin RE, Raad II, Safdar A. Streptococcus pneumoniae infections in 47 hematopoietic stem cell transplantation recipients: clinical characteristics of infections and vaccine-breakthrough infections, 1989–2005. Medicine (Baltimore). 2007;86(2):69–77.

    PubMed  Google Scholar 

  55. Kulkarni S, Powles R, Treleaven J, Riley U, Singhal S, Horton C, et al. Chronic graft versus host disease is associated with long-term risk for pneumococcal infections in recipients of bone marrow transplants. Blood. 2000;95(12):3683–6.

    CAS  PubMed  Google Scholar 

  56. Peleg AY, Husain S, Qureshi ZA, Silveira FP, Sarumi M, Shutt KA, et al. Risk factors, clinical characteristics, and outcome of Nocardia infection in organ transplant recipients: a matched case-control study. Clin Infect Dis. 2007;44(10):1307–14.

    PubMed  Google Scholar 

  57. Roy V, Weisdorf D. Mycobacterial infections following bone marrow transplantation: a 20 year retrospective review. Bone Marrow Transplant. 1997;19(5):467–70.

    CAS  PubMed  Google Scholar 

  58. Gaviria JM, Garcia PJ, Garrido SM, Corey L, Boeckh M. Nontuberculous mycobacterial infections in hematopoietic stem cell transplant recipients: characteristics of respiratory and catheter-related infections. Biol Blood Marrow Transplant. 2000;6(4):361–9.

    CAS  PubMed  Google Scholar 

  59. Safdar A, Papadopoulous EB, Armstrong D. Listeriosis in recipients of allogeneic blood and marrow transplantation: thirteen year review of disease characteristics, treatment outcomes and a new association with human cytomegalovirus infection. Bone Marrow Transplant. 2002;29(11):913–6.

    CAS  PubMed  Google Scholar 

  60. Grijalva CG, Chen L, Delzell E, Baddley JW, Beukelman T, Winthrop KL, et al. Initiation of tumor necrosis factor-alpha antagonists and the risk of hospitalization for infection in patients with autoimmune diseases. JAMA. 2011;306(21):2331–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  61. Dixon WG, Abrahamowicz M, Beauchamp ME, Ray DW, Bernatsky S, Suissa S, et al. Immediate and delayed impact of oral glucocorticoid therapy on risk of serious infection in older patients with rheumatoid arthritis: a nested case-control analysis. Ann Rheum Dis. 2012;71(7):1128–33.

    CAS  PubMed  Google Scholar 

  62. Saag KG, Koehnke R, Caldwell JR, Brasington R, Burmeister LF, Zimmerman B, et al. Low dose long-term corticosteroid therapy in rheumatoid arthritis: an analysis of serious adverse events. Am J Med. 1994;96(2):115–23.

    CAS  PubMed  Google Scholar 

  63. Jick SS, Lieberman ES, Rahman MU, Choi HK. Glucocorticoid use, other associated factors, and the risk of tuberculosis. Arthritis Rheum. 2006;55(1):19–26.

    PubMed  Google Scholar 

  64. Targeted tuberculin testing and treatment of latent tuberculosis infection. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. This is a Joint Statement of the American Thoracic Society (ATS) and the Centers for Disease Control and Prevention (CDC). This statement was endorsed by the Council of the Infectious Diseases Society of America. (IDSA), September 1999, and the sections of this statement. Am J Respir Crit Care Med. 2000;161(4 Pt 2):S221–47.

    Google Scholar 

  65. Dong YH, Chang CH, Lin Wu FL, Shen LJ, Calverley PM, Lofdahl CG, et al. Use of inhaled corticosteroids in patients with COPD and the risk of TB and influenza: a systematic review and meta-analysis of randomized controlled trials. a systematic review and meta-analysis of randomized controlled trials. Chest. 2014;145(6):1286–97.

    CAS  PubMed  Google Scholar 

  66. Yale SH, Limper AH. Pneumocystis carinii pneumonia in patients without acquired immunodeficiency syndrome: associated illness and prior corticosteroid therapy. Mayo Clin Proc. 1996;71(1):5–13.

    CAS  PubMed  Google Scholar 

  67. Sepkowitz KA, Brown AE, Telzak EE, Gottlieb S, Armstrong D. Pneumocystis carinii pneumonia among patients without AIDS at a cancer hospital. JAMA. 1992;267(6):832–7.

    CAS  PubMed  Google Scholar 

  68. Cruz T, Reboucas G, Rocha H. Fatal strongyloidiasis in patients receiving corticosteroids. N Engl J Med. 1966;275(20):1093–6.

    CAS  PubMed  Google Scholar 

  69. Higenbottam TW, Heard BE. Opportunistic pulmonary strongyloidiasis complicating asthma treated with steroids. Thorax. 1976;31(2):226–33.

    CAS  PubMed  PubMed Central  Google Scholar 

  70. Ghosh K, Ghosh K. Strongyloides stercoralis septicaemia following steroid therapy for eosinophilia: report of three cases. Trans R Soc Trop Med Hyg. 2007;101(11):1163–5.

    PubMed  Google Scholar 

  71. Winthrop KL. Infections and biologic therapy in rheumatoid arthritis: our changing understanding of risk and prevention. Rheum Dis Clin North Am. 2012;38(4):727–45.

    PubMed  Google Scholar 

  72. Strangfeld A, Eveslage M, Schneider M, Bergerhausen HJ, Klopsch T, Zink A, et al. Treatment benefit or survival of the fittest: what drives the time-dependent decrease in serious infection rates under TNF inhibition and what does this imply for the individual patient? Ann Rheum Dis. 2011;70(11):1914–20.

    CAS  PubMed  Google Scholar 

  73. Curtis JR, Patkar N, Xie A, Martin C, Allison JJ, Saag M, et al. Risk of serious bacterial infections among rheumatoid arthritis patients exposed to tumor necrosis factor alpha antagonists. Arthritis Rheum. 2007;56(4):1125–33.

    CAS  PubMed  Google Scholar 

  74. Giles JT, Bartlett SJ, Gelber AC, Nanda S, Fontaine K, Ruffing V, et al. Tumor necrosis factor inhibitor therapy and risk of serious postoperative orthopedic infection in rheumatoid arthritis. Arthritis Rheum. 2006;55(2):333–7.

    PubMed  Google Scholar 

  75. Galloway JB, Hyrich KL, Mercer LK, Dixon WG, Ustianowski AP, Helbert M, et al. Risk of septic arthritis in patients with rheumatoid arthritis and the effect of anti-TNF therapy: results from the British Society for Rheumatology Biologics Register. Ann Rheum Dis. 2011;70(10):1810–4.

    CAS  PubMed  Google Scholar 

  76. Wallis RS, Broder M, Wong J, Beenhouwer D. Granulomatous infections due to tumor necrosis factor blockade: correction. Clin Infect Dis. 2004;39(8):1254–5.

    PubMed  Google Scholar 

  77. Slifman NR, Gershon SK, Lee JH, Edwards ET, Braun MM. Listeria monocytogenes infection as a complication of treatment with tumor necrosis factor alpha-neutralizing agents. Arthritis Rheum. 2003;48(2):319–24.

    CAS  PubMed  Google Scholar 

  78. Lanternier F, Tubach F, Ravaud P, Salmon D, Dellamonica P, Bretagne S, et al. Incidence and risk factors of Legionella pneumophila pneumonia during anti-tumor necrosis factor therapy: a prospective French study. Chest. 2013;144(3):990–8.

    PubMed  Google Scholar 

  79. Winthrop KL, Baxter R, Liu L, Varley CD, Curtis JR, Baddley JW, et al. Mycobacterial diseases and antitumour necrosis factor therapy in USA. Ann Rheum Dis. 2013;72(1):37–42.

    CAS  PubMed  Google Scholar 

  80. Mohan AK, Cote TR, Block JA, Manadan AM, Siegel JN, Braun MM. Tuberculosis following the use of etanercept, a tumor necrosis factor inhibitor. Clin Infect Dis. 2004;39(3):295–9.

    CAS  PubMed  Google Scholar 

  81. Centers for Disease C, Prevention. Tuberculosis associated with blocking agents against tumor necrosis factor-alpha – California, 2002–2003. MMWR Morb Mortal Wkly Rep. 2004;53(30):683–6.

    Google Scholar 

  82. Wendling D, Auge B, Bettinger D, Lohse A, Le Huede G, Bresson-Hadni S, et al. Reactivation of a latent precore mutant hepatitis B virus related chronic hepatitis during infliximab treatment for severe spondyloarthropathy. Ann Rheum Dis. 2005;64(5):788–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  83. Ostuni P, Botsios C, Punzi L, Sfriso P, Todesco S. Hepatitis B reactivation in a chronic hepatitis B surface antigen carrier with rheumatoid arthritis treated with infliximab and low dose methotrexate. Ann Rheum Dis. 2003;62(7):686–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  84. Ueno Y, Tanaka S, Shimamoto M, Miyanaka Y, Hiyama T, Ito M, et al. Infliximab therapy for Crohn’s disease in a patient with chronic hepatitis B. Dig Dis Sci. 2005;50(1):163–6.

    PubMed  Google Scholar 

  85. Michel M, Duvoux C, Hezode C, Cherqui D. Fulminant hepatitis after infliximab in a patient with hepatitis B virus treated for an adult onset still's disease. J Rheumatol. 2003;30(7):1624–5.

    PubMed  Google Scholar 

  86. Singh JA, Furst DE, Bharat A, Curtis JR, Kavanaugh AF, Kremer JM, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2012;64(5):625–39.

    CAS  PubMed  Google Scholar 

  87. McDonald JR, Zeringue AL, Caplan L, Ranganathan P, Xian H, Burroughs TE, et al. Herpes zoster risk factors in a national cohort of veterans with rheumatoid arthritis. Clin Infect Dis. 2009;48(10):1364–71.

    PubMed  Google Scholar 

  88. Strangfeld A, Listing J, Herzer P, Liebhaber A, Rockwitz K, Richter C, et al. Risk of herpes zoster in patients with rheumatoid arthritis treated with anti-TNF-alpha agents. JAMA. 2009;301(7):737–44.

    CAS  PubMed  Google Scholar 

  89. Kaur N, Mahl TC. Pneumocystis jiroveci (carinii) pneumonia after infliximab therapy: a review of 84 cases. Dig Dis Sci. 2007;52(6):1481–4.

    CAS  PubMed  Google Scholar 

  90. Seddik M, Meliez H, Seguy D, Viget N, Cortot A, Colombel JF. Pneumocystis jiroveci (carinii) pneumonia following initiation of infliximab and azathioprine therapy in a patient with Crohn’s disease. Inflamm Bowel Dis. 2004;10(4):436–7.

    PubMed  Google Scholar 

  91. Wallis RS, Broder M, Wong J, Lee A, Hoq L. Reactivation of latent granulomatous infections by infliximab. Clin Infect Dis. 2005;41 Suppl 3:S194–8.

    CAS  PubMed  Google Scholar 

  92. Farizo KM, Buehler JW, Chamberland ME, Whyte BM, Froelicher ES, Hopkins SG, et al. Spectrum of disease in persons with human immunodeficiency virus infection in the United States. JAMA. 1992;267(13):1798–805.

    CAS  PubMed  Google Scholar 

  93. Popovich KJ, Hota B, Aroutcheva A, Kurien L, Patel J, Lyles-Banks R, et al. Community-associated methicillin-resistant Staphylococcus aureus colonization burden in HIV-infected patients. Clin Infect Dis. 2013;56(8):1067–74.

    PubMed  PubMed Central  Google Scholar 

  94. Zervou FN, Zacharioudakis IM, Ziakas PD, Rich JD, Mylonakis E. Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus colonization in HIV infection: a meta-analysis. Clin Infect Dis. 2014;59(9):1302–11.

    CAS  PubMed  PubMed Central  Google Scholar 

  95. Catherinot E, Lanternier F, Bougnoux ME, Lecuit M, Couderc LJ, Lortholary O. Pneumocystis jirovecii Pneumonia. Infect Dis Clin North Am. 2010;24(1):107–38.

    PubMed  Google Scholar 

  96. Miller RF, Huang L, Walzer PD. Pneumocystis pneumonia associated with human immunodeficiency virus. Clin Chest Med. 2013;34(2):229–41.

    PubMed  Google Scholar 

  97. Tanner DC, Weinstein MP, Fedorciw B, Joho KL, Thorpe JJ, Reller L. Comparison of commercial kits for detection of cryptococcal antigen. J Clin Microbiol. 1994;32(7):1680–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  98. Hussong J, Peterson LR, Warren JR, Peterson LC. Detecting disseminated Mycobacterium avium complex infections in HIV-positive patients. The usefulness of bone marrow trephine biopsy specimens, aspirate cultures, and blood cultures. Am J Clin Pathol. 1998;110(6):806–9.

    CAS  PubMed  Google Scholar 

  99. Eledrisi MS, Verghese AC. Adrenal insufficiency in HIV infection: a review and recommendations. Am J Med Sci. 2001;321(2):137–44.

    CAS  PubMed  Google Scholar 

  100. Neumann AU, Tubiana R, Calvez V, Robert C, Li TS, Agut H, et al. HIV-1 rebound during interruption of highly active antiretroviral therapy has no deleterious effect on reinitiated treatment. Comet Study Group AIDS. 1999;13(6):677–83.

    CAS  Google Scholar 

  101. Josephson F. Drug-drug interactions in the treatment of HIV infection: focus on pharmacokinetic enhancement through CYP3A inhibition. J Intern Med. 2010;268(6):530–9.

    CAS  PubMed  Google Scholar 

  102. Foisy MM, Yakiwchuk EM, Hughes CA. Induction effects of ritonavir: implications for drug interactions. Ann Pharmacother. 2008;42(7):1048–59.

    CAS  PubMed  Google Scholar 

  103. Fernandez J, Acevedo J, Castro M, Garcia O, de Lope CR, Roca D, et al. Prevalence and risk factors of infections by multiresistant bacteria in cirrhosis: a prospective study. Hepatology. 2012;55(5):1551–61.

    PubMed  Google Scholar 

  104. Fagiuoli S, Colli A, Bruno R, Burra P, Craxi A, Gaeta GB, et al. Management of infections in cirrhotic patients: report of a consensus conference. Dig Liver Dis. 2014;46(3):204–12.

    PubMed  Google Scholar 

  105. Fernandez J, Navasa M, Gomez J, Colmenero J, Vila J, Arroyo V, et al. Bacterial infections in cirrhosis: epidemiological changes with invasive procedures and norfloxacin prophylaxis. Hepatology. 2002;35(1):140–8.

    PubMed  Google Scholar 

  106. Plessier A, Denninger MH, Consigny Y, Pessione F, Francoz C, Durand F, et al. Coagulation disorders in patients with cirrhosis and severe sepsis. Liver Int. 2003;23(6):440–8.

    PubMed  Google Scholar 

  107. Fernandez J, Gomez C, Ruiz del Arbol L, Durandez R, Serradilla R, Guarner C, et al. Norfloxacin vs ceftriaxone in the prophylaxis of infections in patients with advanced cirrhosis and hemorrhage. Gastroenterology. 2006;131(4):1049–56; quiz 285.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA

    Judith Anesi MD

  2. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Valerianna Amorosa MD

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  2. Valerianna Amorosa MD
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Correspondence to Judith Anesi MD .

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  1. Trauma, Surgical Critical Care, Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Niels D. Martin

  2. Trauma, Surgical Critical Care, Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Lewis J. Kaplan

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© 2016 Springer International Publishing Switzerland

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Anesi, J., Amorosa, V. (2016). Immunocompromised Patients. In: Martin, N.D., Kaplan, L.J. (eds) Principles of Adult Surgical Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-33341-0_34

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  • DOI: https://doi.org/10.1007/978-3-319-33341-0_34

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33339-7

  • Online ISBN: 978-3-319-33341-0

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