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Infections in People With Impaired Defenses

By Allan R. Tunkel, MD, PhD, Professor of Medicine and Medical Services; Associate Dean for Medical Education, Warren Alpert Medical School of Brown University

Many disorders, drugs, and other treatments can cause a breakdown in the body’s natural defenses. Such a breakdown can lead to infections, which can even be caused by microorganisms that normally live harmlessly on or in the body. A breakdown can result from the following:

  • Extensive burns: Risk of infection is increased because damaged skin cannot prevent invasion by harmful microorganisms.

  • Medical procedures: During a procedure, foreign material may be introduced into the body, increasing the risk of infection. Such material includes catheters inserted into the urinary tract or a blood vessel, tubes inserted into the windpipe, and sutures placed under the skin.

  • Drugs that suppress the immune system: These drugs include cancer chemotherapy drugs, drugs used to prevent rejection after an organ transplant (such as azathioprine, methotrexate, and cyclosporine), and corticosteroids (such as prednisone).

  • Radiation treatments: Such treatments may suppress the immune system, particularly when bone marrow is exposed to radiation.

  • AIDS: The ability to fight certain infections decreases dramatically in people with AIDS, especially late in the disease. People with AIDS are at particular risk of opportunistic infections (infections by microorganisms that generally do not cause infection in people with a healthy immune system). Also, many common infections cause people with AIDS to become more severely ill.

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