OSH Infection in the Immunocompromised Host

There is an increasing number of immunocompromised patients across a widening range of specialities in medicine. Patients with underlying malignancy, as well as transplant patients, are now living longer in a vulnerable immune state. Previously, patients were only seen by small specialist transplant, haematology, or oncology teams. Modern techniques mean that patients undergoing care in many specialities such as dermatology, rheumatology, gastroenterology, and acute general medicine, are being immunosuppressed to modify their underlying disease, and treated directly by their own specialists. The most pressing problems that these patients suffer from are usually related to fever and infection.

The Oxford Specialist Handbook of Infection in the Immunocompromised Host is a comprehensive guide for medical staff caring for immunocompromised patients in a hospital setting. Divided into three sections, it is the ideal source for clear, up-to-date information needed on the ward. The book starts with a background of the field, followed by a section that provides a 'host', or patient-centred, approach to presentations in different immunocompromised states. It discusses the assessment, investigation, and management of clinical syndromes in patients with primary immunodeficiency, HIV infection, immunodeficiency as a result of therapeutic immunosuppression, haematological and solid organ malignancy, and immunodeficiency related to organ transplant. In addition, it covers medical conditions resulting in defective immunity, such as diabetes, mellitus, and chronic renal failure, and provides information on travel in the immunocompromised host. The third section provides a pathogen-centred approach to the investigation and management of viral, bacterial, parasitic, and fungal infections of particular relevance to the immunocompromised host.

Combining hospital and laboratory guidelines with recent research, the Oxford Specialist Handbook of Infection in the Immunocompromised Host highlights the importance of diagnoses and empirical treatments. Ideal for medical staff working in infectious diseases, ITU, haematology and oncology, transplants, HIV/GUM, rheumatology, and general medicine, it also considers the diagnostic dilemmas encountered in a clinical setting. This handbook is also a valuable resource for when preparing for the UK SCE examinations in these topics, and the MRCP.

Simon Fox, Locum Consultant in Infectious Diseases, Sheffield Teaching Hospitals NHS Foundation Trust; Nuffield Department of Tropical Medicine, University of Oxford,Brian Angus, Associate Professor and Reader in Infectious Diseases, Director Oxford Centre for Tropical Medicine, University of Oxford,Angela Minassian, Chief Investigator on Clinical Vaccine Trials; and Honorary Consultant, Jenner Institute, University of Oxford; and Heart of England NHS Trust,Thomas Rawlinson, The Jenner Institute, University of Oxford, Wellcome Trust Research Training Fellow

Simon Fox was raised in Kenya, East Africa and did an intial BSc in Zoology before working in Uganda and Somalia on the ecology of tropical infections. He completed his undergraduate medical education at the University of Oxford. Following this, in addition to NHS posts in general medicine and infectious diseases, he has worked in Papua New Guniea and Thailand.


Brian Angus trained in Glasgow and Oxford. He has done research on artemisinin in severe malaria in Thailand and Ghana. Currently he is working in vaccine development using controlled human challenge models and viral vector vaccines.

Angela Minassian trained in Cambridge, London and Oxford, and was appointed as a Consultant in Infectious Diseases in Birmingham in 2014. Her main research interest is in human challenge models of infection, and her DPhil involved development of a human challenge model against tuberculosis, using BCG. She is currently working to establish the first human challenge model for P. vivax malaria in Europe.

Thomas Rawlinson trained at Liverpool, Harvard and Oxford. He has worked as a GP in the Hebrides before re-training in Infectious Diseases. He is currently a Wellcome Trust Research Training Fellow at the Jenner Institute, University of Oxford and developing a vaccine against blood stage Plasmodium vivax malaria. His fascination with tropical diseases has been fuelled by work in West Africa, Asia and South America.

Section 1: Background
1. Introduction
2. The immune system
Section 2: Clinical approach
3. Primary immunodeficiency syndromes
4. Immunosuppressive drugs
5. HIV infection
6. Neutropenic sepsis in patients with leukaemia, lymphoma and solid organ tumours
7. Infections in solid organ transplant recipients
8. Infections in haematopoietic stem cell transplant recipients
9. Medical conditions associated with immunocompromise
10. Travel in the immunocompromised
Section 3: Microbiology
11. Viruses
12. Parasites
13. Fungi
14. Bacteria