title: Infections in the Non-Transplanted Immunocompromised Host.
abstract: BACKGROUND
  Discoveries regarding the basic mechanisms underlying malignant disease, rheumatologic disorders, and autoimmune diseases have led to the development of many new therapeutic modalities that target components of the immune system. Most of these are antibodies or fusion proteins that interfere with components of the immune response that are playing both pathological and protective roles, resulting in variable degrees of immune suppression and a higher risk of infectious complications.
  
  
  METHODS
  Review of the English-language literature.
  
  
  RESULTS
  As these modalities are often used in combination with more traditional methods of immune suppression (e.g., corticosteroids), an increasing spectrum of infection is being encountered by clinicians. Febrile neutropenia requires rapid assessment and initiation of empiric broad-spectrum antimicrobial therapy. Persistence despite this therapy should prompt further investigation for drug-resistant bacteria and invasive fungal disease. Important pathogens to consider in patients with neutropenia, chronic steroid exposure, or underlying gastrointestinal malignant diseases include fungi (Candida, Aspergillus) and atypical bacteria (Nocardia, Clostridium septicum).
  
  
  CONCLUSIONS
  This review focuses on observations regarding the greater risk of infections associated with many of these new biological modalities, as well as some specific infectious complications that may be encountered more commonly by the surgical consultant.
authors.affiliation: Department of Infectious Diseases, John Peter Smith Hospital , Fort Worth, Texas.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Tessier
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007239:Infections / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents