2. PENDAHULUAN
The human body has a complex system of
protective mechanisms to prevent
infection, involving both the adaptive
(cellular and humoral) immune system and
the innate defense system (e.g.
skin, mucous membranes).

3. PENGERTIAN

4. TERBAGI DUA KELOMPOK
 Defects, accidental or intentional, in the
body's innate defense mechanisms;
 Deficiencies in the adaptive immune
response.

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. OTHER IMPORTANT OPPORTUNIST
PATHOGENS
A. 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

12. 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.

13. 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.

14. 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

15. 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

16. 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

17. 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

18. 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

19. OTHER IMPORTANT OPPORTUNIST
PATHOGENS
 VIRUSES
 EBV infection
- Associated with the development of
Hodgkin's disease,
- Non-Hodgkin's lymphomas in individuals
with HIV infection,
- Post-transplantation lymphoproliferative
disease
- Smooth-muscle tumors in
immunosuppressed children

20. 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.

21. 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

22. 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