Infeksi pada klien dengan immunocompromised
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Infeksi pada klien dengan immunocompromised






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Infeksi pada klien dengan immunocompromised Infeksi pada klien dengan immunocompromised Presentation Transcript

  • PENDAHULUANThe human body has a complex system ofprotective mechanisms to preventinfection, involving both the adaptive(cellular and humoral) immune system andthe innate defense system (, mucous membranes).
  • TERBAGI DUA KELOMPOK Defects, accidental or intentional, in the bodys innate defense mechanisms; Deficiencies in the adaptive immune response.
  • GANGGUAN SISTEM IMUN Primary immunodeficiency - Inherited or occurs by exposure in utero to environmental factors or by other unknown mechanisms. chronic granulomatous disease (Congenital defects in phagocytic cells ) - Rare , and varies in severity depending upon the type of defect - Immunoglobulin deficiency
  • GANGGUAN SISTEM IMUN Secondary or acquired immunodeficiency - Due to an underlying disease state) or occurs as a result of treatment for a disease. - Malnutrition is a common and the most important cause of acquired immunodeficiency - Treatment of disease can also cause immunosuppression
  • INFEKSI KLIEN IMUNOCOMPROMISED KARENA FAKTOR FISIK Infeksi luka bakar The most important pathogens in burn wounds are: - Pseudomonas aeruginosa and other Gram- negative rods - Staphylococcus aureus - Streptococcus pyogenes; - other streptococci; - enterococci
  • INFEKSI KLIEN IMUNOCOMPROMISED KARENA FAKTOR FISIK Traumatic injury and surgical wound infections - Staph. aureus is the most important cause of surgical wound infection - Catheter-associated infection of the urinary tract is common - Staphylococci are the most common cause of intravenous and peritoneal dialysis catheter infections
  • INFEKSI KLIEN IMUNOCOMPROMISED KARENA FAKTOR FISIK Infections of plastic devices in situ Staph. epidermidis is the most common cause of prosthetic valve and joint infections Infections due to compromised clearance mechanisms Stasis predisposes to infection, and in health the body functions to prevent stasis
  • INFECTIONS ASSOCIATED WITH SECONDARY ADAPTIVE IMMUNODEFICIENCY Hematologic malignancy and bone marrow transplant infections A lack of circulating neutrophils following bone marrow failure predisposes to infection, Gram-negative rods such as Escherichia coli and P. aeruginosa, Staph. epidermidis dan fungi Solid organ transplant infections Most infections occur within 3-4 months of transplantation AIDS infections The clinical definition of AIDS includes the presence of one or more opportunistic infections
  • OTHER IMPORTANT OPPORTUNIST PATHOGENSA. Fungi Candida is the most common fungal pathogen in compromised patients , manisfestasi beragam tergantung area : - Chronic mucocutaneous candidiasis - Oropharyngeal and esophageal candidiasis - Gastrointestinal candidiasis - Disseminated candidiasis
  • FUNGI Cryptococcus neoformans - Most common in people with impaired cell-mediated immunity - An opportunistic yeast with a worldwide distribution. - Cause infection in the immunocompetent host, - Infection is seen more frequently in people with impaired cell-mediated immunity.
  • FUNGI Histoplasma capsulatum - Infection may occur years after exposure - Highly infectious fungus that causes an acute but benign pulmonary infection in healthy people - Produce a chronic progressive disseminated disease. - Endemic only in tropical parts of the world and notably in the so-called histo belt of the central USA, particularly in the Ohio and Mississippi river valleys. - The natural habitat of the organism is the soil. - Transmitted by the airborne route and the fungal spores are deposited in the alveoli, from whence the fungus spreads via the lymphatics to the regional lymph nodes.
  • FUNGI Aspergillus spp - Usually a fatal disease in diseases of the lung - Cause of invasive disease in compromised patients - Usually in profoundly neutropenic patients or those receiving high dose corticosteroids). - Found in soil, but have a worldwide distribution - Infection is spread by the airborne route, and the lung is the site of invasion in almost every case
  • FUNGI Pneumocystis jiroveci (formerly P. carinii) - Causes symptomatic disease in people with deficient cellular immunity - An atypical fungus which appears to be widespread, - High incidence of P. jiroveci pneumonia in patients receiving immunosuppressive therapy to prevent transplant rejection and in people with HIV. - Very rare to find Pneumocystis infection in any other site in the body
  • OTHER IMPORTANT OPPORTUNIST PATHOGENS BACTERIA  Nocardia asteroides Uncommon opportunist pathogen with a worldwide distribution contain two pathogenic genera, Actinomyces and Nocardia  Mycobacterium avium Intracellulare disease is often a terminal event in AIDS This includes disseminated infection with Mycobacterium tuberculosis and Mycobacterium avium-intracellulare (Mycobacterium avium complex or MAC
  • OTHER IMPORTANT OPPORTUNIST PATHOGENS PROTOZOA AND HELMINTHS  Cryptosporidium and Isospora belli - Cause severe diarrhea in AIDS - Protozoan parasite that causes human disease - Well known to veterinarians as an animal pathogen
  • PROTOZOA AND HELMINTHS Strongyloides stercoralis - Immunosuppression may lead to reactivation of dormant parasitic - Roundworm that remains dormant for years following initial infection, - May be reactivated to produce massive autoinfection in the immunosuppressed patient
  • OTHER IMPORTANT OPPORTUNIST PATHOGENS VIRUSES  EBV infection - Associated with the development of Hodgkins disease, - Non-Hodgkins lymphomas in individuals with HIV infection, - Post-transplantation lymphoproliferative disease - Smooth-muscle tumors in immunosuppressed children
  • VIRUSES Adenovirus infection Primary and reactivated adenovirus infections can result in disseminated disease in immunocompromised hosts, in particular pediatric and adult bone marrow transplant recipients.
  • VIRUSES HepatitisB infection Hepatitis B virus infection has an immunopathological basis, with jaundice occurring after cytotoxic T cells have lysed the hepatitis B surface-antigen- bearing hepatocytes
  • VIRUSES Polyoma viruses BK or JC viruses, acquired via the respiratory tract and latent in the kidney, are often detected in the urine of bone marrow transplant recipients