General Features Of Immunodeficiency Diseases

Before beginning our discussion of individual diseases, it is important to summarize some general features of immunodeficiencies.

• The principal consequence of immunodeficiency is an increased susceptibility to infection. The nature of the infection in a particular patient depends largely on the component of the immune system that is defective (Table 20-1). Deficient humoral immunity usually results in increased susceptibility to infection by encapsulated, pus-forming bacteria and some viruses, whereas defects in cell-mediated immunity lead to infection by viruses and other intracellular microbes. Combined deficiencies in both humoral and cellmediated immunity make patients susceptible to infection by all classes of microorganisms. Immunodeficient patients often present with infections by microbes that are commonly encountered but effectively eliminated by healthy persons; such infections are said to be opportunistic.

TABLE 20-1 Features of Immunodeficiencies Affecting T or B Lymphocytes

Feature

B Cell Deficiency

T Cell Deficiency

Susceptibility to infection

Pyogenic bacteria (otitis, pneumonia, meningitis, osteomyelitis), enteric bacteria and viruses, some parasites

Pneumocystis jiroveci, many viruses, atypical mycobacteria, fungi

Diagnosis

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