Respiratory infections in HIV-negative immunocompromised patients

The number of immunosuppressed patients is increasing, with many being managed by community physicians. Encouraging success in vaccinating some patients with Hodgkinʼs disease against encapsulated organisms has been reported. The significance of and management of tuberculosis in solid organ transplants is being defined. Fungal infection remains a problem, but pathogenesis and treatment are being clarified. The overall incidence of Pneumocystis carinii pneumonia is low, but it is being seen in patients without malignant disease, especially those with Wegenerʼs granulomatosis. Many authors have tried to establish risk factors that will allow development of clear indications for prophylaxis in these patients. New approaches to cytomegalovirus infection are discussed as well as the role of community-acquired viruses in causing disease in the immunosuppressed population.