If a person is immunocompromised, what particular pathogen(s) are they most susceptible to?

[Jaybee00]

If you are immunocompromised, which pathogens are you most susceptible to (versus normals)?

Bacteria
Viruses
Protozoans
Fungi

Does it depend on what substance you used to achieve immunocompromised status?

For example, does rituximab leave you more vulnerable to certain types of infections versus cyclophosphamide or Daratumumab, etc.?

 

[Jonathan Edwards]

Does it depend on what substance you used to achieve immunocompromised status?

For example, does rituximab leave you more vulnerable to certain types of infections versus cyclophosphamide or Daratumumab, etc.?

Yes, the immune system can be compromised in a whole lot of different ways.

If you lack neutrophils you tend to be at risk of bacterial infections and sepsis. Cyclophosphamide hits neutrophils quite hard.
If you lack T cells, as in AIDS, you get problems with specific 'ooportunistic' organisms like pneumocystis carinii pneumonia. Interestingly, Campath depletes T cells but is not associated with much in the way of infection problems.
B cell depletion has been associated, very rarely, with JC virus leucoencephalopathy, although most of the cases had some other immune problem as well.
TNF inhibition is particularly a risk factor for tuberculosis reactivation in people who have been exposed in the past without knowing it.

 

[Kitty]

Does it depend on what substance you used to achieve immunocompromised status?

I think it might depend more on the target of the therapy—which parts of the immune system are modified.

There's probably a lot of variation between individuals, I guess? At my age you tend to know a good few people on drugs that mean they're classed as immune compromised, but they don't all see an increase in opportunistic infections. Some seem able to clear viruses like Covid as well as anyone else.