Immunocompromise

Our immune system protects us against germs.ย  If, for various reasons, it fails to work as well as it should, a person is considered โ€œimmunocompromised.โ€ย  Sometimes this failure is temporary; for example, during viral influenza (โ€œthe Fluโ€), itโ€™s easier to develop a fatal Pneumonia.ย  The same with significant dehydration or hypothermia.ย  Some immunocompromising conditions have less effect than others.

We clinicians are always alert for patients with conditions conferring greater degrees of immunocompromise.ย  For one, theyโ€™re more susceptible to common infections, and may be susceptible to rare infections which wouldnโ€™t be able to attack those of us with normal immune function.ย  Also, symptoms of infection often play out differently if youโ€™re immunocompromised.ย  For example, the immune system is what gives us a fever, which feels lousy but helps control the germ.ย  If an immunocompromised person is unable to mount a fever, we may overlook the possibility of their having a possible-lethal infection.

The following are conditions or factors that contribute to serious degrees of immunocompromise:

  • Elderly :  Defined by biologic age more than physical, especially if they have numerous medical conditions.  We define “elderly” as “over 65,โ€ but once you yourself are almost there, youโ€™ll probably ratch it up a bit.
  • Debilitated, Malnourished, bad Alcoholics.
  • Active Cancer, especially if on Chemotherapy.
  • Kidney Failure, Liver Failure, Adrenal Failure, bad Heart Failure, etc.
  • Immunosuppressive Medications, (after Organ Transplant, for Lupus, etc).
  • No spleen (removed, usually for trauma)
  • Chronic Rheumatologic disorders (Rheumatoid Arthritis, Lupus, Scleroderma, etc)
  • Sickle Cell Anemia
  • AIDS and not taking HIV medications (well-controlled HIV isn’t a risk).

Other conditions like diabetes, chronic smoking, injection drug us, severe obesity, etc. also affect our immune systems, but not to the same degree.

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