Skip to main content

Infections in Immunocompromised Individuals

  • Living reference work entry
  • First Online:
  • 2176 Accesses

Abstract

A patient is immunocompromised because of either an acquired or inherited immune deficiency disorder. The causes of inherited immunodeficiency are numerous, such as human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), solid organ transplant, bone marrow transplant (BMT), cancer, chemotherapy, lymphoma, glucocorticoid therapy, splenectomy, and trauma. Immunocompromised patients are at increased risk for life-threatening infectious complications that should be treated aggressively as early as possible. Clinical neuroradiology plays an important role in diagnosing and therapy monitoring of central nervous system (CNS) infections in immunocompromised individuals.

Infections can be viral, bacterial, fungal, or parasitic in origin and will depend on the severity of immunodeficiency, the cause of immunodeficiency, and also the period of the most intensive immunosuppression. This chapter will discuss the most common CNS infections in immunosuppressed patients and focus on radiological techniques used for their detection and differentiation.

figure a

This publication is endorsed by: European Society of Neuroradiology (www.esnr.org)

This is a preview of subscription content, log in via an institution.

References

  • Berger JR, Aksamit AJ, Clifford DB, Davis L, Koralnik IJ, Sejvar JJ, et al. PML diagnostic criteria: consensus statement from the AAN neuroinfectious disease section. Neurology. 2013;80:1430–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dibble EH, Boxerman JL, Baird GL, Donahue JE, Rogg JM. Toxoplasmosis versus lymphoma: cerebral lesion characterization using DSC-MRI revisited. Clin Neurol Neurosurg. 2017;152:84–9.

    Article  PubMed  Google Scholar 

  • Eggers E, Arendt G, Hahn K, et al. HIV-1-associated neurocognitive disorder: epidemiology, pathogenesis, diagnosis, and treatment. J Neurol. 2017;264(8):1715–27.

    Article  PubMed  PubMed Central  Google Scholar 

  • Post MJ, Thurnher MM, Clifford DB, et al. CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 1: overview and discussion of progressive multifocal leukoencephalopathy-immune reconstitution inflammatory syndrome and cryptococcal-immune reconstitution inflammatory syndrome. AJNR Am J Neuroradiol. 2013a;34:1297–307.

    Article  CAS  PubMed  Google Scholar 

  • Post MJ, Thurnher MM, Clifford DB, et al. CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 2: discussion of neuro-immune reconstitution inflammatory syndrome with and without other pathogens. AJNR Am J Neuroradiol. 2013b;34(7):1308–18.

    Article  CAS  PubMed  Google Scholar 

Further Readings/Websites

  • Bowen LN, Smith B, Reich D, et al. HIV-associated opportunistic CNS infections: pathophysiology, diagnosis and treatment. Nat Rev Neurol. 2016;12:662–74.

    Article  CAS  PubMed  Google Scholar 

  • Clifford DB. HIV-associated neurocognitive disorder. Curr Opin Infect Dis. 2017;30(1):117–22.

    PubMed  PubMed Central  Google Scholar 

  • Deigendesch N, Costa Nunez J, Stenzel W. Parasitic and fungal infections. Handb Clin Neurol. 2017;145:245–62.

    Article  PubMed  Google Scholar 

  • Gottumukkala RV, Romero JM, Riascos RF, Rojas R, Glikstein RS. Imaging of the brain in patients with human immunodeficiency virus infection. Top Magn Reson Imaging. 2014;23(5):275–91.

    Article  PubMed  Google Scholar 

  • Martin-Iguacel R, Ahlström MG, Touma M, et al. Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era. J Infect. 2017;75(3):263–73.

    Article  PubMed  Google Scholar 

  • Sainz-de-la-Maza S, Casado JL, Pérez-Elías MJ, et al. Incidence and prognosis of immune reconstitution inflammatory syndrome in HIV-associated progressive multifocal leukoencephalopathy. Eur J Neurol. 2016;23(5):919–25.

    Article  CAS  PubMed  Google Scholar 

  • Schwartz S, Kontoyiannis DP, Harrison T, Ruhnke M. Advances in the diagnosis and treatment of fungal infections of the CNS. Lancet Neurol. 2018;17(4):362–72.

    Article  PubMed  Google Scholar 

  • Scutari R, Alteri C, Perno CF, et al. The role of HIV infection in neurologic injury. Brain Sci. 2017;7(4):38.

    Article  CAS  PubMed Central  Google Scholar 

  • Williamson PR, Jarvis JN, Panackal AA, et al. Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy. Nat Rev Neurol. 2017;13(1):13–24.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Majda M. Thurnher .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Thurnher, M.M. (2018). Infections in Immunocompromised Individuals. In: Barkhof, F., Jager, R., Thurnher, M., Rovira Cañellas, A. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-61423-6_48-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-61423-6_48-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-61423-6

  • Online ISBN: 978-3-319-61423-6

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics