Infections in the Non-Transplanted Immunocompromised Host.

Area of Science:

• Immunology
• Oncology
• Rheumatology

Background:

• Advances in understanding malignant, rheumatologic, and autoimmune diseases have spurred development of immune-targeting therapies.
• Many novel treatments, including antibodies and fusion proteins, modulate immune responses, leading to immune suppression and increased infection susceptibility.

Purpose of the Study:

• To review the heightened risk of infections associated with new biologic immunomodulatory therapies.
• To highlight specific infectious complications relevant to surgical consultants.

Main Methods:

• Literature review of English-language publications.

Main Results:

• Combination therapies (biologics with corticosteroids) broaden the spectrum of encountered infections.
• Febrile neutropenia necessitates prompt broad-spectrum antimicrobial treatment.
• Persistent infections warrant investigation for drug-resistant bacteria and invasive fungal infections, particularly in neutropenic patients or those with gastrointestinal malignancies.

Conclusions:

• Biologic immunomodulatory agents significantly elevate the risk of diverse infections.
• Surgical consultants should be aware of specific opportunistic pathogens like Candida, Aspergillus, Nocardia, and Clostridium septicum in at-risk patients.