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7 - Infections and immunity

Published online by Cambridge University Press:  01 June 2011

James C. Barton ,
Corwin Q. Edwards ,
Pradyumna D. Phatak ,
Robert S. Britton  and
Bruce R. Bacon
By
James C. Barton ,
Corwin Q. Edwards ,
Pradyumna D. Phatak ,
Robert S. Britton  and
Bruce R. Bacon
James C. Barton
Affiliation:
University of Alabama, Birmingham
Corwin Q. Edwards
Affiliation:
University of Utah Medical Center
Pradyumna D. Phatak
Affiliation:
University of Rochester Medical Center, New York
Robert S. Britton
Affiliation:
St Louis University, Missouri
Bruce R. Bacon
Affiliation:
St Louis University, Missouri
James C. Barton
Affiliation:
University of Alabama, Birmingham
Corwin Q. Edwards
Affiliation:
University of Utah School of Medicine, Salt Lake City
Pradyumna D. Phatak
Affiliation:
University of Rochester Medical Center, New York
Robert S. Britton
Affiliation:
St Louis University, Missouri
Bruce R. Bacon
Affiliation:
St Louis University, Missouri
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Summary

Persons with hemochromatosis or other iron overload conditions are susceptible to infection by some organisms that rarely cause illness in people with normal body iron stores (Table 7.1). Bacteria require iron for their own metabolism. Hosts with iron overload may thus have increased susceptibility to infection with certain bacteria. Vibrio vulnificus and Yersinia species are well-known causes of life-threatening infections in persons with iron overload. Listeria monocytogenes and organisms associated with zygomycosis sometimes cause severe infections in persons who have hemochromatosis, other types of liver disease, diabetes mellitus, immunodeficiency, or skin wounds. Infections with Escherichia coli are common in persons without iron overload, although unusually severe E. coli infections have been reported in some patients who had hemochromatosis or iron overload. Infections with these organisms also occur in patients without iron overload, many of whom have non-iron conditions that may increase their susceptibility to infection. Some persons with hemochromatosis or iron overload have abnormal phagocyte function, low levels of one or more blood lymphocyte subsets, or selective deficiency of immunoglobulin isotypes.

Vibrio vulnificus infections

Epidemiology

V. vulnificus is a motile, halophilic, free-living Gram-negative bacillus that grows as normal marine flora and is distributed worldwide in warm, coastal waters. It can cause very serious infections in persons with iron overload, cirrhosis, or decreased immunity. V. vulnificus causes three major categories of infections: (1) primary septicemia occurs due to ingestion of uncooked oysters or other raw shellfish (or of cooked food contaminated with seawater drippings); (2) wound infections develop after contact of superficial wounds with seawater that contains V. vulnificus; and (3) gastroenteritis, associated with raw shellfish consumption, is accompanied by vomiting, diarrhea, abdominal pain, and positive stool cultures for V. vulnificus, but blood cultures are negative and there is no associated wound.

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Handbook of Iron Overload Disorders , pp. 112 - 126
Publisher: Cambridge University Press
Print publication year: 2010

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