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Pathogens in children with severe combined immune deficiency disease or AIDS
Insights
Children with severe combined immune deficiency (SCID) and acquired immune deficiency syndrome (AIDS) experienced frequent and severe microbial infections. Paramyxoviruses and disseminated viral infections caused the most deaths in both patient groups.
Area of Science:
- Immunology
- Infectious Diseases
- Pediatrics
Background:
- Severe combined immune deficiency (SCID) and acquired immune deficiency syndrome (AIDS) compromise the immune system, increasing susceptibility to infections.
- Understanding the spectrum of opportunistic infections in these vulnerable populations is crucial for diagnosis and management.
Purpose of the Study:
- To compare the frequency and severity of microbial infections in children with SCID and AIDS.
- To identify the primary causes of mortality in these patient groups.
Main Methods:
- Retrospective analysis of medical records of 15 children with SCID and 8 with AIDS.
- Categorization and quantification of infections by pathogen type (viral, bacterial, mycotic, parasitic).
- Assessment of infection severity and identification of causes of death.
Main Results:
- A high burden of infections was observed, with 35 viral, 23 bacterial, 19 mycotic, and 13 parasitic infections documented.
- Mortality was high, with 19 out of 23 patients dying from infections.
- Key causes of death included Pneumocystis carinii pneumonia, paramyxoviral giant-cell pneumonia, and disseminated viral infections.
- Paramyxoviruses were notably implicated in seven cases of giant-cell pneumonia.
- Viral enteric infections were common in both SCID and AIDS patients.
- The range of pathogens and illness severity were comparable between SCID and AIDS cohorts.
Conclusions:
- Children with SCID and AIDS are susceptible to a wide array of severe microbial infections.
- Paramyxoviruses represent a significant and emerging threat, particularly causing fatal pneumonia.
- Infections pose a major cause of mortality in both SCID and AIDS, with similar patterns observed between the two conditions.
Abstract:
We evaluated the frequency and severity of illnesses caused by various microbial pathogens in 15 children with severe combined immune deficiency disease (SCID) and 8 with acquired immune deficiency syndrome (AIDS). There were 35 viral, 23 bacterial, 19 mycotic and 13 parasitic infections. Nineteen of the 23 patients died of infection; Pneumocystis carinii pneumonia, giant-cell pneumonia due to paramyxoviruses and various disseminated viral infections were responsible for most deaths in both groups. The emerging role of paramyxoviruses was illustrated by the fact that they were responsible for giant-cell pneumonia in seven patients. Viral enteric infections were frequent in both groups. The variety of infectious microorganisms and the severity of resulting illnesses in the patients with AIDS were similar to those in the patients with SCID.