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Pneumonia - weakened immune system

  • Definition
  • Alternative Names
    • Pneumonia in immunodeficient patient; Pneumonia - immunocompromised host

  • Causes
    • People whose immune system is not working well are less able to fight off germs. This makes them prone to infections from germs that do not often cause disease in healthy people. They are also more vulnerable to regular causes of pneumonia, which can affect anyone.

      Your immune system may be weakened or not work well because of:

      • Bone marrow transplant
      • Chemotherapy
      • HIV infection
      • Leukemia, lymphoma, and other conditions that harm your bone marrow
      • Autoimmune disorders
      • Medicines (including steroids, and those used to treat cancer and control autoimmune diseases)
      • Organ transplant (including kidney, heart, and lung)
  • Symptoms
    • Symptoms may include:

      • Cough (may be dry or produce mucus-like, greenish, or pus-like sputum)
      • Chills with shaking
      • Easy fatigue
      • Fever
      • General discomfort, uneasiness, or ill feeling (malaise)
      • Headache
      • Loss of appetite
      • Nausea and vomiting
      • Sharp or stabbing chest pain that gets worse with deep breathing or coughing
      • Shortness of breath

      Other symptoms that may occur:

      • Heavy sweating or night sweats
      • Stiff joints (rare)
      • Stiff muscles (rare)
  • Exams and Tests
  • Treatment
    • Antibiotics or antifungal medicines may be used, depending on the type of germ that is causing the infection. Antibiotics are not helpful for viral infections. You may need to stay in the hospital during the early stages of the illness.

      Oxygen and treatments to remove fluid and mucus from the respiratory system are often needed.

  • Outlook (Prognosis)
    • Factors that may lead to a worse outcome include:

      • The pneumonia that is caused by a fungus.
      • The person has a very weak immune system.
  • Possible Complications
    • Complications may include:

      • Respiratory failure (the person needs machines to assist breathing)
      • Sepsis
      • Spread of the infection
      • Death
  • When to Contact a Medical Professional
    • Call your health care provider if you have a weakened immune system and you have symptoms of pneumonia.

  • Prevention
    • If you have a weakened immune system, you may receive daily antibiotics to prevent some types of pneumonia.

      Ask your provider if you should receive the influenza (flu) and pneumococcal (pneumonia) vaccines.

      Practice good hygiene. Thoroughly wash your hands with soap and water:

      • After being outdoors
      • After changing a diaper
      • After doing housework
      • After going to the bathroom
      • After touching body fluids, such as mucus or blood
      • After using the telephone
      • Before handling food or eating

      Other things you can do to reduce your exposure to germs include:

      • Keep your house clean.
      • Stay away from crowds.
      • Ask visitors who have a cold to wear a mask or not to visit.
      • DO NOT do yard work or handle plants or flowers (they can carry germs).
  • References
    • Donnelly JP, Blijlevens NMA, van der Velden WJFM. Infections in the immunocompromised host. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 309.

      Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72. PMID: 17278083 www.ncbi.nlm.nih.gov/pubmed/17278083.

      Marr KA. Approach to fever and suspected infection in the compromised host. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 281.