[Impaired immunity: risk groups and consequences for general practice].
- Due to medication use, comorbidities and/or age, an increasing number of patients have an impaired immunity to infection.- Impaired immunity may lead to an increased risk of (opportunistic) infection, complications from infections, and difficulties in the diagnosis of infections.- Guided by clinical parameters, a general practitioner can classify an impaired immunity as 'clinically irrelevant', 'limitedly relevant' or 'potentially serious'.- Tocilizumab impairs the production of CRP, which makes it unreliable as an infection parameter.- In case of a suspected infection in patients with severe immunosuppression, it will often be necessary to consult a specialist as quickly as possible about further diagnostic procedures and the need for, type and administration route of antimicrobials.- In patients with an impaired immunity, adaptation of the antibiotic policy and prophylactic measures, such as vaccination, may be indicated.- Patients with (functional) asplenia should immediately start antibiotic treatment in case of fever, pending clinical evaluation by a physician.
Nederlands Huisartsen Genootschap, Utrecht.
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W
Opstelten
J W J
JW
Bijlsma
L B S
LB
Gelinck
C M J
CM
Hielkema
Th J M
TJ
Verheij
W
W
van Eden
D058006:General Practice / Q000379:methods*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D009894:Opportunistic Infections / Q000276:immunology* / Q000517:prevention & control*; D012306:Risk