Disruption of Normal Barriers that May Predispose to Infections in PTS with Cancer
| Type of Defense | Specific Lesion | Cells Involved | Organisms | Cancer Association(s) | Disease(s) |
|---|---|---|---|---|---|
| Physical barrier | Breaks in skin | Skin epithelial cells | Staphylococci, streptococci | Head and neck, squamous cell carcinoma | Cellulitis, extensive skin infection |
| Emptying of fluid collections | Occlusion of orifices: ureters, bile duct, colon | Luminal epithelial cells | Gram-negative bacilli | Renal, ovarian, biliary tree, metastatic diseases of many cancers | Rapid, overwhelming bacteremia; urinary tract infection |
| Lymphatic function | Node dissection | Lymph nodes | Staphylococci, streptococci | Breast cancer surgery | Cellulitis |
| Splenic clearance of microorganisms | Splenectomy | Splenic reticuloendothelial cells | Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Babesia, Capnocytophaga canimorsus | Hodgkin's disease, leukemia | Rapid, overwhelming sepsis |
| Phagocytosis | Lack of granulocytes | Granulocytes (neutrophils) | Staphylococci, streptococci, enteric organisms, fungi | Acute myeloid and acute lymphocytic leukemias, hairy cell leukemia | Bacteremia |
| Humoral immunity | Lack of antibody | B cells | S. pneumoniae, H. influenzae, N. meningitidis | Chronic lymphocytic leukemia, multiple myeloma | Infections with encapsulated organisms, sinusitis, pneumonia |
| Cellular immunity | Lack of T cells | T cells and macrophages | Mycobacterium tuberculosis, Listeria, herpesviruses, fungi, intracellular parasites | Hodgkin's disease, leukemia, T-cell lymphoma | Infections with intracellular bacteria, fungi, parasites; virus reactivation |