This paper is only available as a PDF. To read, Please Download here.
Abstract
Superinfection in the compromised host often poses a diagnostic and therapeutic dilemma
for the physician who is concerned that a perplexing array of microorganisms might
be involved. We believe that the differential diagnosis list can often be narrowed
considerably by separating superinfection in the compromised host into five convenient
categories: (1) infections due to the underlying disease itself; (2) infections due
to the underlying disease plus therapy for that disease; (3) infections due solely
to medicaments, operations, or procedures; (4) infections increased in severity but
probably not in incidence; and (5) societally related infections.
Use of this or a similar categorization should result in a more rational approach
to differential diagnosis, should encourage a more focused diagnostic work-up, should
reduce the necessity for invasive procedures, should provide the microbiology laboratory
information about specific organisms that should be sought sedulously, and should
permit the selection of a more rational antimicrobial regimen prior to the availability
of definitive microbiologic information.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Infections associated with immunologic deficiency diseases.Med Clin North Am. 1974; 58: 649-659
- Opportunistic infection in children.J Pediatr. 1975; 87: 507-514
- Opportunistic infection in children.J Pediatr. 1975; 87: 677-694
- Opportunistic infection in children.J Pediatr. 1975; 87: 852-866
- Infectious risk factors in the immunosuppressed host.Am J Med. 1973; 54: 453-460
- Pulmonary infection in the compromised host.Am Rev Respir Dis. 1976; 114: 359-394
- Disseminated histoplasmosis in immunologically suppressed patients: occurrence in a non-endemic area.Am J Med. 1978; 64: 94-100
- Listeriosis.in: Hafner, New York1961: 122-123
- Stroud RM: Complement and host defense against infection.J Pediatr. 1978; 90: 169-179
- Bactericidal and opsonic activity against Neisseria gonorrhoeae in sera from patients with disseminated gonococcal infection.J Infec Dis. 1976; 134: 450-462
- Gonococci causing disseminated gonococcal infection are resistant to the bactericidal action of normal human sera.J Clin Invest. 1976; 58: 1163-1173
- Bacterial infection and sickle cell anemia.Medicine (Baltimore). 1971; 50: 97-112
- Deficiency of pneumococcal serum opsonizing activity in sickle cell disease.N Engt J Med. 1968; 279: 459-466
- An abnormality of the alternate pathway of complement activation in sickle cell disease.N Engl J Med. 1973; 288: 803-808
- Alternative pathway activity in sera from patients with sickle cell disease.Clin Exp Immunol. 1976; 23: 56-60
- Complement activation in asymptomatic patients with sickle cell anemia.Clin Exp Immunol. 1979; 36: 130-139
- Serum opsonization of Salmonella in sickle cell anemia.Am J Med. 1978; 64: 388-395
- Louria DB. Effect of alcohol and various diseases on leukocyte mobilization, phagocytosis, and intracellular bacterial killing.N Engl J Med. 1970; 282: 123-128
- Chemotaxis of polymorphonuclear leukocytes from patients with diabetes mellitus.N Engl J Med. 1971; 284: 621-627
- Host defense in diabetes mellitus: the feckless phagocyte during poor control and ketoacidosis.Diabetes. 1970; 19: 364
- Infection in diabetes: predisposing factors.Postgrad Med. 1976; 59: 160-164
- Leukocyte function in juvenile diabetes mellitus: humoral and cellular aspects.J Pediatr. 1972; 81: 979-982
- Impaired leukocyte function in patients with poorly controlled diabetes.Diabetes. 1974; 23: 9-15
- The wide spectrum of cryptococcal infections.Am J Med. 1972; 53: 315-322
- Infection and diabetes mellitus.Diabetic Care. 1980; 3: 187-197
- Damage to hyphal forms of fungi by human leukocytes in vitro.Am J Pathol. 1978; 91: 313-323
- Bilateral renal aspergillosis.J Urol. 1975; 113: 8-11
- Malignant external otitis: A severe form of otitis in diabetic patients.Am J Med. 1976; 61: 298-302
- Bacteriology of necrotizing fasciitis.Am J Surg. 1977; 134: 52-56
- Torulopsis glabrata renal infection.Am J Med. 1974; 57: 217-224
- Generalized Yersinia enterocolitica infection.J Infect Dis. 1975; 131: 447-451
- Lysosomal stability during phagocytosis of Aspergillus flavus spores by alveolar macrophages of cortisone-treated mice.Science. 1968; 160: 79-81
- Diagnostic and prognostic value of clinical and laboratory findings in cryptococcal meningitis: a followup study of 40 patients.N Engl J Med. 1964; 270: 59-67
- Bacterial infection and the asplenic host: a review.J Trauma. 1976; 16: 662-668
- Hazard of overwhelming infection after splenectomy in childhood.N Engl J Med. 1969; 276: 1225-1229
- Fulminant pneumococcal infections in normal asplenic hosts.Arch Intern Med. 1977; 137: 1526-1530
- Splenectomy and infection.Arch Intern Med. 1977; 137: 1516-1517
- Postsplenectomy sepsis.in: Rosenberg H.S. Bolande R.P. Perspectives in pediatric pathology. Yearbook Medical, Chicago1973: 285
- Relation between splenectomy and subsequent infection.Arch Dis Child. 1962; 37: 398-414
- The hazard of infection following splenectomy in children.Am J Dis Chiild. 1968; 116: 1-12
- Properidin levels in splenectomized persons.in: 3rd ed. Proc Soc Exp Biol Med. 102. 1959: 150-154
- Defective phagocytosis due to tuiftsin deficiency in splenectomized subjects.Am J Dis Child. 1973; 125: 663-665
- Influence of gastric acidity on bacterial and parasitic enteric infection.Ann Intern Med. 1973; 78: 271-276
- Pulmonary tuberculosis after gastric resection.Am J Surg. 1976; 131: 668-671
- Tuberculosis after jejunoileal bypass for obesity.Ann Intern Med. 1977; 87: 574-576
- Infusion thrombophlebitis and infection with various cannulas.Lancet. 1975; II: 150-152
- Bacterial proliferation in platelet products stored at room temperature: transfusion-induced Enterobacter sepsis.N Engl J Med. 1971; 285: 429-433
- Salmonella septicemia from platelet transfusions: study of an outbreak traced to a hematogenous carrier of Salmonella choleraesuis.Ann Intern Med. 1973; 78: 633-641
- Catheter complications in total parenteral nutrition.N Engl J Med. 1974; 290: 757-761
- Infection control in intravenous therapy.Ann Intern Med. 1973; 79: 867-887
- Complications with heparin lock needles: a prospective evaluation.Ann Intern Med. 1976; 85: 583-586
- Indwelling arterial catheters as a source of nosocomial bacteremia: An outbreak caused by Flavobacterium species.N Engl J Med. 1975; 292: 1099-1102
- Infections of Scribner and Brescia arteriovenous shunts.Br Med J. 1971; 3: 408-409
- Complications of peritoneal dialysis.South Med J. 1976; 69: 584-587
- Morbid Mortal Weekly Rep. 1978; 27: 307-309
- Nursery outbreak of peritonitis with pneumoperitoneum probably caused by thermometerinduced rectal perforation.Am J Epidemiol. 1976; 104: 632-644
- Salmonella Oslo: a focal outbreak.Am J Med. 1976; 60: 203-208
- Infections of cerebrospinal fluid shunts: epidemiology' clinical manifestations and therapy.J Infect Dis. 1975; 131: 543-552
- Shunt fluid aspiration: an adjunct in the diagnosis of cerebrospinal fluid shunt infections.Am J Dis Child. 1975; 129: 220-222
- Microbial skin flora of selected cancer patients and hospital personnel.J Clin Microbiol. 1976; 3: 14-20
- Miliary tuberculosis following homograft valve replacement.Thorax. 1976; 31: 101-106
- The effects of four antimicrobial drug regimens on sputum superinfection in hospitalized patients.Am Rev Resp Dis. 1962; 85: 649-665
- Bacterial colonization and clinical superinfection of the respiratory tract complicating antibiotic treatment of pneumonia.J Infect Disc. 1969; 119: 597
- Treatment of mixed bacterial infections with clindamycin and gentamicin.J Infect Dis. 1977; 135: 574-579
- Antibiotic-associated colitis.Clin Gastroenterol. 1979; 8: 783-801
- The influence of cortisone on experimental fungus infection in mice.J Clin Invest. 1960; 39: 1435-1449
- The macrophage tubercle bacillus relationship and resistance to tuberculosis.Ann NY Acad Sci. 1968; 154: 157-166
- Infectious complications in cancer patients treated with chemical immunosuppressive agents.Transplant Proc. 1973; 5: 1245-1248
- Syndrome of hyperinfection with Strongyloides stercoralis: Report of two cases and review of 101 previously described cases.Rev Infect Dis. 1981; 3: 397-407
- The unusual severity of Mycoplasma pneumonia in children with sickle cell disease.N Engl J Med. 1972; 287: 164-167
- Infections in patients with immunodeficiency syndrome: report of 4 cases.J Infect Dis. 1977; 127: 388-393
- Severe Mycoplasma pneumonia with pleural effusions in a patient with sickle cell hemoglobin C (SC) disease.Am J Med. 1979; 66: 707-710
- Disseminated pulmonary blastomycosis in an immunosuppressed patient.Am Rev Resp Dis. 1976; 113: 83-86
- Coccidioidomycosis in compromised hosts.Medicine (Baltimore). 1974; 54: 377-395
- Histoplasmosis in immunosuppressed patients.Am J Med. 1978; 64: 923-932
- Surgery for coccidioidomycosis in 52 diabetic patients with special reference to related immunologic factors.J Thorac Cardiovasc Surg. 1978; 75: 680-687
- Disseminated histoplasmosis: Clinical and pathological correlations.Medicine (Baltimore). 1980; 59: 1-33
- Toxoplasmosis in the compromised host.Ann Intern Med. 1976; 84: 193-199
- Pneumocystis carinii infection.Medicine (Baltimore). 1973; 52: 23-51
- Pneumocystis carinii pneumonia: a cluster of 11 cases.Ann Intern Med. 1975; 82: 72
- Human babesiosis on Nahtucket Island' clinical features.Ann Intern Med. 1977; 86: 6-9
- Malaria complicating neoplastic disease.Arch Intern Med. 1976; 136: 807-810
- Studies on influenza in the pandemic of 1957–1958. II. Pulmonary complications of influenza.J Clin Invest. 1959; 38: 213-265
- Oropharyngeal colonization of chronic alcoholics by gram-negative bacilli and other potential pathogens (abstr).Clin Res. 1976; 24: 349A
- Characteristics of pneumonias caused by Escherichia coli.N Engl J Med. 1967; 227: 115-122
- Community acquired Acinetobacter pneumonia.Am J Med. 1979; 67: 39-43
- Actinomycosis of the female genital track.Obstet Gynecol. 1976; 48: 341-346
- Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency.N Engl J Med. 1981; 305: 1425-1431
- An outbreak of community-acquired Pneumocystis carinii pneumonia' initial manifestation of cellular immune dysfunction.N Engl J Med. 1981; 305: 1431-1438
- Severe acquired immunodeficiency in male homosexuals' manifested by chronic perianal ulcerative herpes simplex lesions.N Engl J Med. 1981; 305: 1439-1444
- Lancet. 1981; II (Editorial:): 1325-1326
- Pulmonary alveolar macrophage Defender against bacterial infection of the lung.J Clin Invest. 1974; 54: 519-528
- Nutrition and infection: field study in Guatemalan villages.Arch Environ Health. 1968; 16: 233-234
- Torulopsis glabrata pneumonia in a malnourished woman.South Med J. 1979; 72: 1477-1479
Article Info
Publication History
Accepted:
April 26,
1982
Identification
Copyright
© 1982 Published by Elsevier Inc.
