Sepsis in Immunocompromised Hosts

Over the past 20‐ 30 years there has been a dramatic increase in the number of people living with immunosuppression. Cancer chemotherapy and the treatment of haematological disease transiently put people at risk, while the immunosuppression required for solid organ transplants and for immunemediated diseases, such as systemic lupus erythematosus, is more prolonged. In addition to these iatrogenic causes of impaired immunity, there is an increasing burden of HIV infection and better survival of individuals with primary immunodeficiency. This article will attempt to outline the defects in host defences in some of these groups, and show how the presentation, diagnosis and management of sepsis may differ from that seen in normal hosts. The abnormal hosts mentioned above fail to respond appropriately to infecting pathogens and opportunist organisms because of defects in one or more of the components of the immune system: i neutropenia and other phagocytic defects