Cerny A
Departement Medizin, Inselspital, Bern.
Schweiz Med Wochenschr. 1997 Mar 1;127(9):360-6.
Recurrent infections in individual patients prompt concern regarding an underlying immunodeficiency. It is often difficult to make a distinction between "normal" and abnormally frequent occurrence of infections. Infectious diseases are the result of a series of complicated interactions between host factors, pathogen properties and epidemiological circumstances. This paper reviews the role of non-specific and antigen-specific host factors relevant to the management of a patient with suspected immunodeficiency. The most important effector mechanisms of immune defence are outlined and the consequences of their failure with respect to specific infections are discussed. Analysis of the clinical presentation, pathophysiology and microorganisms involved offers clues as to which part of the immune system is failing in an individual patient. Based on this, further tests will confirm or exclude an underlying immunodeficiency. The paper concludes with an overview of relevant therapeutic and prophylactic options.
个体患者反复感染引发了对潜在免疫缺陷的关注。区分感染的“正常”发生频率和异常频繁发生往往很困难。传染病是宿主因素、病原体特性和流行病学情况之间一系列复杂相互作用的结果。本文综述了与疑似免疫缺陷患者管理相关的非特异性和抗原特异性宿主因素的作用。概述了免疫防御的最重要效应机制，并讨论了其功能衰竭对特定感染的影响。对临床表现、病理生理学和所涉及微生物的分析为个体患者免疫系统的哪一部分出现功能障碍提供了线索。基于此，进一步的检查将证实或排除潜在的免疫缺陷。本文最后概述了相关的治疗和预防选择。
