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The introduction was made more robust, and sources were added. The “types of infections” section was reworked: broken into sections by pathogen types, and short descriptions and sources added to each pathogen listed. Pathogens previously listed but lacking a strong foundation in existing review literature were removed. A brief definition was added to the beginning of the causes section. A section was added on the role of opportunistic infection in AIDS.
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An '''opportunistic infection''' is an [[infection]] caused by [[pathogen]]s ([[bacteria]], [[fungus|fungi]], [[Parasitism|parasites]] or [[virus]]es) that take advantage of an opportunity not normally available. These opportunities can stem from a variety of sources, such as a [[weakened immune system]] (as can occur in [[AIDS|acquired immunodeficiency syndrome]] or when being treated with [[Immunosuppressive drug|immunosuppressive drugs]], as in [[Treatment of cancer|cancer treatment]]),<ref name=":1">{{Citation|last=Justiz Vaillant|first=Angel A.|title=Immunodeficiency|date=2021|url=http://www.ncbi.nlm.nih.gov/books/NBK500027/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=29763203|access-date=2021-03-09|last2=Qurie|first2=Ahmad}}</ref> an altered [[microbiome]] (such as a disruption in [[Gut flora|gut microbiota]]), or breached [[Integumentary system|integumentary]] barriers (as in [[penetrating trauma]]). Many of these pathogens do not cause disease in a healthy host that has a non-compromised immune system, and can, in some cases, act as [[Commensalism|commensals]] until the balance of the immune system is disrupted.<ref name=":2">{{Cite journal|last=Schroeder|first=Max R.|last2=Stephens|first2=David S.|date=2016-09-21|title=Macrolide Resistance in Streptococcus pneumoniae|url=http://journal.frontiersin.org/Article/10.3389/fcimb.2016.00098/abstract|journal=Frontiers in Cellular and Infection Microbiology|volume=6|doi=10.3389/fcimb.2016.00098|issn=2235-2988|pmc=PMC5030221|pmid=27709102}}</ref><ref>{{Cite journal|last=Achermann|first=Y.|last2=Goldstein|first2=E. J. C.|last3=Coenye|first3=T.|last4=Shirtliff|first4=M. E.|date=2014-07-01|title=Propionibacterium acnes: from Commensal to Opportunistic Biofilm-Associated Implant Pathogen|url=https://cmr.asm.org/content/27/3/419|journal=Clinical Microbiology Reviews|language=en|volume=27|issue=3|pages=419–440|doi=10.1128/CMR.00092-13|issn=0893-8512|pmc=PMC4135900|pmid=24982315}}</ref> Opportunistic infections can also be attributed to pathogens that cause mild illness in healthy individuals but lead to more serious illness when given the opportunity to take advantage of an immunocompromised host.<ref>{{Cite journal|last=Caballero|first=Mauricio T.|last2=Polack|first2=Fernando P.|date=2018-02-20|title=Respiratory syncytial virus is an “opportunistic” killer|url=http://doi.wiley.com/10.1002/ppul.23963|journal=Pediatric Pulmonology|language=en|volume=53|issue=5|pages=664–667|doi=10.1002/ppul.23963|pmc=PMC5947624|pmid=29461021}}</ref>
An '''opportunistic infection''' is an [[infection]] caused by [[pathogen]]s ([[bacteria]], [[virus]]es, [[fungus|fungi]], or [[protozoa]]) that take advantage of an opportunity not normally available, such as a host with a [[immunodeficiency|weakened immune system]], an altered [[microbiota]] (such as a disrupted [[gut flora|gut microbiota]]), or breached [[integumentary system|integumentary]] barriers. Many of these pathogens do not cause disease in a healthy host that has a normal immune system. However, a compromised immune system, which is seriously debilitated and has lowered resistance to infection, a [[penetrating trauma|penetrating injury]], or a lack of competition from normal [[commensalism|commensals]] presents an opportunity for the pathogen to infect.

== Types of infections==
== Types of opportunistic infections==
{{Further|Immunodeficiency}}
{{Further|Immunodeficiency}}


A wide variety of pathogens are involved in opportunistic infection and can cause a similarly wide range in pathologies. A partial list of opportunistic pathogens and their associated presentations includes:
A partial listing of opportunistic organisms includes:


=== Bacteria ===
* ''[[Aspergillus]]'' sp.

* ''[[Candida albicans]]''
* ''[[Clostridioides difficile]]'' (formerly known as ''Clostridium difficile'') is a species of bacteria that is known to cause gastrointestinal infection and is typically associated with the [[Hospital-acquired infection|hospital setting]]. <ref>{{Cite journal|last=Czepiel|first=Jacek|last2=Dróżdż|first2=Mirosław|last3=Pituch|first3=Hanna|last4=Kuijper|first4=Ed J.|last5=Perucki|first5=William|last6=Mielimonka|first6=Aleksandra|last7=Goldman|first7=Sarah|last8=Wultańska|first8=Dorota|last9=Garlicki|first9=Aleksander|last10=Biesiada|first10=Grażyna|date=2019-04-03|title=Clostridium difficile infection: review|url=http://link.springer.com/10.1007/s10096-019-03539-6|journal=European Journal of Clinical Microbiology & Infectious Diseases|language=en|volume=38|issue=7|pages=1211–1221|doi=10.1007/s10096-019-03539-6|issn=0934-9723|pmc=PMC6570665|pmid=30945014}}</ref><ref>{{Cite journal|last=Guh|first=Alice Y.|last2=Kutty|first2=Preeta K.|date=2018-10-02|title=Clostridioides difficile Infection|url=http://annals.org/article.aspx?doi=10.7326/AITC201810020|journal=Annals of Internal Medicine|language=en|volume=169|issue=7|pages=ITC49|doi=10.7326/AITC201810020|issn=0003-4819|pmc=PMC6524133|pmid=30285209}}</ref>
* ''[[Clostridium difficile (bacteria)|Clostridium difficile]]''
* ''[[Legionella pneumophila]]'' is a bacterium that causes [[Legionnaires' disease|Legionnaire’s disease]], a [[Respiratory tract infection|respiratory infection]].<ref>{{Cite journal|last=Chahin|first=Abdullah|last2=Opal|first2=Steven M.|date=March 2017|title=Severe Pneumonia Caused by Legionella pneumophila|url=https://linkinghub.elsevier.com/retrieve/pii/S0891552016300952|journal=Infectious Disease Clinics of North America|language=en|volume=31|issue=1|pages=111–121|doi=10.1016/j.idc.2016.10.009|pmc=PMC7135102|pmid=28159171}}</ref><ref>{{Cite journal|last=Berjeaud|first=Jean-Marc|last2=Chevalier|first2=Sylvie|last3=Schlusselhuber|first3=Margot|last4=Portier|first4=Emilie|last5=Loiseau|first5=Clémence|last6=Aucher|first6=Willy|last7=Lesouhaitier|first7=Olivier|last8=Verdon|first8=Julien|date=2016-04-08|title=Legionella pneumophila: The Paradox of a Highly Sensitive Opportunistic Waterborne Pathogen Able to Persist in the Environment|url=http://journal.frontiersin.org/Article/10.3389/fmicb.2016.00486/abstract|journal=Frontiers in Microbiology|volume=7|doi=10.3389/fmicb.2016.00486|issn=1664-302X|pmc=PMC4824771|pmid=27092135}}</ref>
* ''[[Coccidioides immitis]]''
* [[Mycobacterium avium complex|''Mycobacterium avium complex'']] (MAC) is a group of two bacteria, ''M. avium'' and ''M. intracellulare'', that typically co-infect, leading to a lung infection called [[mycobacterium avium-intracellulare infection]]. <ref>{{Cite journal|last=O. Falkinham|first=Joseph|last2=Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia 24061, USA|date=2018|title=Mycobacterium avium complex: Adherence as a way of life|url=http://www.aimspress.com/article/10.3934/microbiol.2018.3.428|journal=AIMS Microbiology|language=en|volume=4|issue=3|pages=428–438|doi=10.3934/microbiol.2018.3.428|issn=2471-1888|pmc=PMC6604937|pmid=31294225}}</ref><ref>{{Cite journal|last=Pan|first=Sheng-Wei|last2=Shu|first2=Chin-Chung|last3=Feng|first3=Jia-Yih|last4=Su|first4=Wei-Juin|date=June 2020|title=Treatment for Mycobacterium avium complex lung disease|url=https://linkinghub.elsevier.com/retrieve/pii/S0929664620301790|journal=Journal of the Formosan Medical Association|language=en|volume=119|pages=S67–S75|doi=10.1016/j.jfma.2020.05.006}}</ref>
* ''[[Cryptococcus neoformans]]''
* ''[[Mycobacterium tuberculosis]]'' is a species of bacteria that causes [[tuberculosis]], a respiratory infection.<ref>{{Cite journal|last=Gordon|first=Stephen V.|last2=Parish|first2=Tanya|date=2018-04-01|title=Microbe Profile: Mycobacterium tuberculosis: Humanity's deadly microbial foe|url=https://www.microbiologyresearch.org/content/journal/micro/10.1099/mic.0.000601|journal=Microbiology|language=en|volume=164|issue=4|pages=437–439|doi=10.1099/mic.0.000601|issn=1350-0872}}</ref>
* ''[[Cryptosporidium]]''
* ''[[Pseudomonas aeruginosa]]'' is a bacterium that can cause respiratory infections. It is frequently associated with [[cystic fibrosis]] and hospital-acquired infections.<ref>{{Cite journal|last=Pang|first=Zheng|last2=Raudonis|first2=Renee|last3=Glick|first3=Bernard R.|last4=Lin|first4=Tong-Jun|last5=Cheng|first5=Zhenyu|date=January-February 2019|title=Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and alternative therapeutic strategies|url=https://linkinghub.elsevier.com/retrieve/pii/S0734975018301976|journal=Biotechnology Advances|language=en|volume=37|issue=1|pages=177–192|doi=10.1016/j.biotechadv.2018.11.013}}</ref>
* ''[[Cytomegalovirus]]''
* ''[[Salmonella]]'' is a [[genus]] of bacteria, known to cause gastrointestinal infections.<ref>{{Cite journal|last=Lamas|first=Alexandre|last2=Miranda|first2=José Manuel|last3=Regal|first3=Patricia|last4=Vázquez|first4=Beatriz|last5=Franco|first5=Carlos Manuel|last6=Cepeda|first6=Alberto|date=January 2018|title=A comprehensive review of non-enterica subspecies of Salmonella enterica|url=https://linkinghub.elsevier.com/retrieve/pii/S0944501317304159|journal=Microbiological Research|language=en|volume=206|pages=60–73|doi=10.1016/j.micres.2017.09.010}}</ref>
* ''[[Geomyces destructans]]'' (bats)
* ''[[Staphylococcus aureus]]'' is a bacterium known to cause skin infections and [[sepsis]], among other pathologies. Notably, ''S. aureus'' has evolved several [[Drug resistance|drug-resistant]] strains, including [[Methicillin-resistant Staphylococcus aureus|MRSA]].<ref>{{Cite journal|last=Jenul|first=Christian|last2=Horswill|first2=Alexander R.|date=2019-03-22|title=Regulation of Staphylococcus aureus Virulence|url=http://www.asmscience.org/content/journal/microbiolspec/10.1128/microbiolspec.GPP3-0031-2018|journal=Microbiology Spectrum|language=en|volume=7|issue=2|doi=10.1128/microbiolspec.GPP3-0031-2018|issn=2165-0497|pmc=PMC6452892|pmid=30953424}}</ref><ref>{{Cite journal|last=Kong|first=Cin|last2=Neoh|first2=Hui-min|last3=Nathan|first3=Sheila|date=2016-03-15|title=Targeting Staphylococcus aureus Toxins: A Potential form of Anti-Virulence Therapy|url=http://www.mdpi.com/2072-6651/8/3/72|journal=Toxins|language=en|volume=8|issue=3|pages=72|doi=10.3390/toxins8030072|issn=2072-6651|pmc=PMC4810217|pmid=26999200}}</ref>
* ''[[Histoplasma capsulatum]]''
* ''[[Streptococcus pneumoniae]]'' is a bacterium that causes respiratory infections. <ref name=":2" />
* ''[[Isospora belli]]''
* ''[[Streptococcus pyogenes]]'' (also known as group A ''Streptococcus'') is a bacterium that can cause a variety of pathologies, including [[impetigo]] and [[Streptococcal pharyngitis|strep throat]], as well as other, more serious, illnesses.<ref>{{Cite journal|last=Jespersen|first=Magnus G.|last2=Lacey|first2=Jake A.|last3=Tong|first3=Steven Y.C.|last4=Davies|first4=Mark R.|date=December 2020|title=Global genomic epidemiology of Streptococcus pyogenes|url=https://linkinghub.elsevier.com/retrieve/pii/S1567134820304408|journal=Infection, Genetics and Evolution|language=en|volume=86|pages=104609|doi=10.1016/j.meegid.2020.104609}}</ref><ref>{{Cite journal|last=Brouwer|first=Stephan|last2=Barnett|first2=Timothy C.|last3=Rivera-Hernandez|first3=Tania|last4=Rohde|first4=Manfred|last5=Walker|first5=Mark J.|date=2016-06-17|title=Streptococcus pyogenes adhesion and colonization|url=http://doi.wiley.com/10.1002/1873-3468.12254|journal=FEBS Letters|language=en|volume=590|issue=21|pages=3739–3757|doi=10.1002/1873-3468.12254}}</ref>
* ''[[JC virus|Polyomavirus JC polyomavirus]]'', the virus that causes [[Progressive multifocal leukoencephalopathy]].

* ''[[Kaposi's Sarcoma]] caused by [[Human herpesvirus 8]] (HHV8)'', also called Kaposi's sarcoma-associated herpesvirus (KSHV)
=== Fungi ===
* ''[[Legionellosis|Legionnaires' Disease (Legionella pneumophila)]]''

* ''[[Microsporidium]]''
* ''[[Aspergillus]]'' is a fungus, commonly associated with respiratory infection.<ref>{{Cite journal|last=Latgé|first=Jean-Paul|last2=Chamilos|first2=Georgios|date=2019-11-13|title=Aspergillus fumigatus and Aspergillosis in 2019|url=https://cmr.asm.org/content/33/1/e00140-18|journal=Clinical Microbiology Reviews|language=en|volume=33|issue=1|pages=e00140–18, /cmr/33/1/CMR.00140–18.atom|doi=10.1128/CMR.00140-18|issn=0893-8512|pmc=PMC6860006|pmid=31722890}}</ref> <ref name=":3">{{Cite journal|last=José|first=Ricardo J.|last2=Periselneris|first2=Jimstan N.|last3=Brown|first3=Jeremy S.|date=June 2020|title=Opportunistic bacterial, viral and fungal infections of the lung|url=https://linkinghub.elsevier.com/retrieve/pii/S1357303920300530|journal=Medicine|language=en|volume=48|issue=6|pages=366–372|doi=10.1016/j.mpmed.2020.03.006|pmc=PMC7206443|pmid=32390758}}</ref>
* ''[[Mycobacterium avium complex]] (MAC) (Nontuberculosis Mycobacterium)''
* ''[[Candida albicans]]'' is a species of fungus that is associated with [[Oral candidiasis|oral thrush]] and gastrointestinal infection. <ref>{{Cite journal|last=Akpan|first=A|date=2002-08-01|title=Oral candidiasis|url=https://pmj.bmj.com/lookup/doi/10.1136/pmj.78.922.455|journal=Postgraduate Medical Journal|volume=78|issue=922|pages=455–459|doi=10.1136/pmj.78.922.455|pmc=PMC1742467|pmid=12185216}}</ref><ref>{{Cite journal|last=Erdogan|first=Askin|last2=Rao|first2=Satish S. C.|date=2015-03-19|title=Small Intestinal Fungal Overgrowth|url=http://link.springer.com/10.1007/s11894-015-0436-2|journal=Current Gastroenterology Reports|language=en|volume=17|issue=4|pages=16|doi=10.1007/s11894-015-0436-2|issn=1522-8037}}</ref>
* ''[[Mycobacterium tuberculosis]]''
* ''[[Coccidioides immitis]]'' is a fungus known for causing [[Coccidioidomycosis]], more commonly known as Valley Fever. <ref>{{Cite journal|last=Mu|first=Anandit|last2=Shein|first2=Thwe Thwe|last3=Jayachandran|first3=Priya|last4=Paul|first4=Simon|date=2017-09-14|title=Immune Reconstitution Inflammatory Syndrome in Patients with AIDS and Disseminated Coccidioidomycosis: A Case Series and Review of the Literature|url=http://journals.sagepub.com/doi/10.1177/2325957417729751|journal=Journal of the International Association of Providers of AIDS Care (JIAPAC)|language=en|volume=16|issue=6|pages=540–545|doi=10.1177/2325957417729751|issn=2325-9582}}</ref>
* [[Pneumocystis pneumonia|''Pneumocystis jirovecii'']], previously known as [[Pneumocystis carinii|''Pneumocystis carinii'' f. ''hominis'']]
* ''[[Cryptococcus neoformans]]'' is a fungus that causes [[cryptococcosis]], which can lead to pulmonary infection as well as nervous system infections, like [[meningitis]].<ref>{{Cite journal|last=Kwon-Chung|first=K. J.|last2=Fraser|first2=J. A.|last3=Doering|first3=T. L.|last4=Wang|first4=Z. A.|last5=Janbon|first5=G.|last6=Idnurm|first6=A.|last7=Bahn|first7=Y.-S.|date=2014-07-01|title=Cryptococcus neoformans and Cryptococcus gattii, the Etiologic Agents of Cryptococcosis|url=http://perspectivesinmedicine.cshlp.org/lookup/doi/10.1101/cshperspect.a019760|journal=Cold Spring Harbor Perspectives in Medicine|language=en|volume=4|issue=7|pages=a019760–a019760|doi=10.1101/cshperspect.a019760|issn=2157-1422|pmc=PMC4066639|pmid=24985132}}</ref> <ref>{{Cite journal|last=Maziarz|first=Eileen K.|last2=Perfect|first2=John R.|date=March 2016|title=Cryptococcosis|url=https://linkinghub.elsevier.com/retrieve/pii/S0891552015000951|journal=Infectious Disease Clinics of North America|language=en|volume=30|issue=1|pages=179–206|doi=10.1016/j.idc.2015.10.006|pmc=PMC5808417|pmid=26897067}}</ref>
* ''[[Pseudomonas aeruginosa]]''
* ''[[Histoplasma capsulatum]]'' is a species of fungus known to cause [[histoplasmosis]], which can present with an array of symptoms, but often involves respiratory infection.<ref>{{Cite journal|last=Horwath|first=Michael C|last2=Fecher|first2=Roger A|last3=Deepe|first3=George S|date=2015-06-10|title=Histoplasma capsulatum , lung infection and immunity|url=https://www.futuremedicine.com/doi/10.2217/fmb.15.25|journal=Future Microbiology|language=en|volume=10|issue=6|pages=967–975|doi=10.2217/fmb.15.25|issn=1746-0913|pmc=PMC4478585|pmid=26059620}}</ref><ref>{{Citation|last=Mittal|first=Jamie|title=Histoplasma Capsulatum: Mechanisms for Pathogenesis|date=2018|url=http://link.springer.com/10.1007/82_2018_114|work=Fungal Physiology and Immunopathogenesis|volume=422|pages=157–191|editor-last=Rodrigues|editor-first=Marcio L.|place=Cham|publisher=Springer International Publishing|language=en|doi=10.1007/82_2018_114|isbn=978-3-030-30236-8|pmc=PMC7212190|pmid=30043340|access-date=2021-03-09|last2=Ponce|first2=Maria G.|last3=Gendlina|first3=Inessa|last4=Nosanchuk|first4=Joshua D.}}</ref>
* ''[[Salmonella]]''
* ''[[Pseudogymnoascus destructans]]'' (formerly known as ''Geomyces destructans'') is a fungus that causes [[white-nose syndrome]] in [[Bat|bats]].<ref>{{Cite journal|last=Seyedmousavi|first=Seyedmojtaba|last2=Bosco|first2=Sandra de M G|last3=de Hoog|first3=Sybren|last4=Ebel|first4=Frank|last5=Elad|first5=Daniel|last6=Gomes|first6=Renata R|last7=Jacobsen|first7=Ilse D|last8=Jensen|first8=Henrik E|last9=Martel|first9=An|last10=Mignon|first10=Bernard|last11=Pasmans|first11=Frank|date=2018-04-01|title=Fungal infections in animals: a patchwork of different situations|url=https://academic.oup.com/mmy/article/56/suppl_1/S165/4925968|journal=Medical Mycology|language=en|volume=56|issue=suppl_1|pages=S165–S187|doi=10.1093/mmy/myx104|issn=1369-3786|pmc=PMC6251577|pmid=29538732}}</ref>
* ''[[Staphylococcus aureus]]''
* ''[[Microsporidia]]'' is a group of fungi that infect species across the [[Animal|animal kingdom]], one species of which can cause [[microsporidiosis]] in immunocompromised human hosts.<ref>{{Cite journal|last=Stentiford|first=G.D.|last2=Becnel|first2=-->J.J.|last3=Weiss|first3=L.M.|last4=Keeling|first4=P.J.|last5=Didier|first5=E.S.|last6=Williams|first6=B-->.A.P.|last7=Bjornson|first7=S.|last8=Kent|first8=M-->.L.|last9=Freeman|first9=M.A.|last10=Brown|first10=M.J.F.|last11=Troemel|first11=E-->.R.|date=April 2016|title=Microsporidia – Emergent Pathogens in the Global Food Chain|url=https://linkinghub.elsevier.com/retrieve/pii/S1471492215002652|journal=Trends in Parasitology|language=en|volume=32|issue=4|pages=336–348|doi=10.1016/j.pt.2015.12.004|pmc=PMC4818719|pmid=26796229}}</ref>
* ''[[Streptococcus pneumoniae]]''
* ''[[Pneumocystis jirovecii]]'' (formerly known as ''Pneumocystis carinii'') is a fungus that causes [[pneumocystis pneumonia]], a respiratory infection.<ref>{{Cite journal|last=Sokulska|first=Magdalena|last2=Kicia|first2=Marta|last3=Wesołowska|first3=Maria|last4=Hendrich|first4=Andrzej B.|date=2015-08-19|title=Pneumocystis jirovecii—from a commensal to pathogen: clinical and diagnostic review|url=http://link.springer.com/10.1007/s00436-015-4678-6|journal=Parasitology Research|language=en|volume=114|issue=10|pages=3577–3585|doi=10.1007/s00436-015-4678-6|issn=0932-0113|pmc=PMC4562001|pmid=26281787}}</ref>
* ''[[Streptococcus pyogenes]]''

* ''[[Toxoplasma gondii]]''
=== Parasites ===

* ''[[Cryptosporidium]]'' is a [[Protozoa|protozoan]] that infects the [[gastrointestinal tract]].<ref>{{Cite journal|last=Gerace|first=Elisabetta|last2=Presti|first2=Vincenzo Di Marco Lo|last3=Biondo|first3=Carmelo|date=2019-12-01|title=Cryptosporidium infection: epidemiology, pathogenesis, and differential diagnosis|url=https://akjournals.com/doi/10.1556/1886.2019.00019|journal=European Journal of Microbiology and Immunology|language=en|volume=9|issue=4|pages=119–123|doi=10.1556/1886.2019.00019|issn=2062-8633|pmc=PMC6945992|pmid=31934363}}</ref>
* ''[[Toxoplasma gondii]]'' is a protozoan, known for causing [[toxoplasmosis]].<ref>{{Cite journal|last=Mendez|first=Oscar A.|last2=Koshy|first2=Anita A.|date=2017-07-20|editor-last=Gubbels|editor-first=Marc-Jan|title=Toxoplasma gondii: Entry, association, and physiological influence on the central nervous system|url=https://dx.plos.org/10.1371/journal.ppat.1006351|journal=PLOS Pathogens|language=en|volume=13|issue=7|pages=e1006351|doi=10.1371/journal.ppat.1006351|issn=1553-7374|pmc=PMC5519211|pmid=28727854}}</ref><ref>{{Cite journal|last=Hunter|first=Christopher A.|last2=Sibley|first2=L. David|date=2012-10-16|title=Modulation of innate immunity by Toxoplasma gondii virulence effectors|url=http://www.nature.com/articles/nrmicro2858|journal=Nature Reviews Microbiology|language=en|volume=10|issue=11|pages=766–778|doi=10.1038/nrmicro2858|issn=1740-1526|pmc=PMC3689224|pmid=23070557}}</ref>

=== Viruses ===

* ''[[Cytomegalovirus]]'' is a family of opportunistic viruses, most frequently associated with respiratory infection.<ref name=":3" /><ref>{{Cite journal|last=Fonseca Brito|first=Luís|last2=Brune|first2=Wolfram|last3=Stahl|first3=Felix R.|date=2019-08-08|title=Cytomegalovirus (CMV) Pneumonitis: Cell Tropism, Inflammation, and Immunity|url=https://www.mdpi.com/1422-0067/20/16/3865|journal=International Journal of Molecular Sciences|language=en|volume=20|issue=16|pages=3865|doi=10.3390/ijms20163865|issn=1422-0067|pmc=PMC6719013|pmid=31398860}}</ref>
* ''[[Human polyomavirus 2|Human Polyomavirus 2]]'' (also known as JC virus) is known to cause [[progressive multifocal leukoencephalopathy]] (PML). <ref>{{Cite journal|last=Bohra|first=Chandrashekar|last2=Sokol|first2=Lubomir|last3=Dalia|first3=Samir|date=2017-11-01|title=Progressive Multifocal Leukoencephalopathy and Monoclonal Antibodies: A Review|url=http://journals.sagepub.com/doi/10.1177/1073274817729901|journal=Cancer Control|language=en|volume=24|issue=4|pages=107327481772990|doi=10.1177/1073274817729901|issn=1073-2748|pmc=PMC5937251|pmid=28975841}}</ref><ref>{{Cite journal|last=Kartau|first=Marge|last2=Sipilä|first2=Jussi OT|last3=Auvinen|first3=Eeva|last4=Palomäki|first4=Maarit|last5=Verkkoniemi-Ahola|first5=Auli|date=2019-12-02|title=Progressive Multifocal Leukoencephalopathy: Current Insights|url=https://www.dovepress.com/progressive-multifocal-leukoencephalopathy-current-insights-peer-reviewed-article-DNND|journal=Degenerative Neurological and Neuromuscular Disease|language=en|volume=Volume 9|pages=109–121|doi=10.2147/DNND.S203405|issn=1179-9900|pmc=PMC6896915|pmid=31819703}}</ref>
* ''[[Kaposi's sarcoma-associated herpesvirus|Human herpesvirus 8]]'' (also known as Kaposi sarcoma-associated herpesvirus) is a virus associated with [[Kaposi's sarcoma|Kaposi sarcoma]], a type of cancer.<ref>{{Cite journal|last=Radu|first=Oana|last2=Pantanowitz|first2=Liron|date=2013-02-01|title=Kaposi Sarcoma|url=http://meridian.allenpress.com/aplm/article/137/2/289/65260/Kaposi-Sarcoma|journal=Archives of Pathology & Laboratory Medicine|language=en|volume=137|issue=2|pages=289–294|doi=10.5858/arpa.2012-0101-RS|issn=1543-2165}}</ref><ref>{{Cite journal|last=Cesarman|first=Ethel|last2=Damania|first2=Blossom|last3=Krown|first3=Susan E.|last4=Martin|first4=Jeffrey|last5=Bower|first5=Mark|last6=Whitby|first6=Denise|date=2019-01-31|title=Kaposi sarcoma|url=http://www.nature.com/articles/s41572-019-0060-9|journal=Nature Reviews Disease Primers|language=en|volume=5|issue=1|pages=9|doi=10.1038/s41572-019-0060-9|issn=2056-676X|pmc=PMC6685213|pmid=30705286}}</ref>


== Causes ==
== Causes ==
[[Immunodeficiency]] or [[immunosuppression]] can be caused by:
[[Immunodeficiency]] or [[immunosuppression]] are characterized by the absence of or disruption in components of the immune system, leading to lower-than-normal levels of immune function and immunity against pathogens.<ref name=":1" /> They can be caused by a variety of factors, including:
* [[Malnutrition]]
* [[Malnutrition]]
* [[Fatigue (medical)|Fatigue]]
* [[Fatigue (medical)|Fatigue]]
Line 71: Line 82:


The lack of or the disruption of [[List of microbiota species of the lower reproductive tract of women|normal vaginal microbiota]] allows the proliferation of [[List of bacterial vaginosis microbiota|opportunistic microorganisms]] and will cause the opportunistic infection - [[bacterial vaginosis]].<ref name="AfricaNel2014">{{cite journal|last1=Africa|first1=Charlene|last2=Nel|first2=Janske|last3=Stemmet|first3=Megan|title=Anaerobes and Bacterial Vaginosis in Pregnancy: Virulence Factors Contributing to Vaginal Colonisation|journal=International Journal of Environmental Research and Public Health|volume=11|issue=7|year=2014|pages=6979–7000|issn=1660-4601|doi=10.3390/ijerph110706979|pmid=25014248|pmc=4113856}}</ref><ref name=Mastro2013>{{cite journal|last1=Mastromarino|first1=Paola|last2=Vitali|first2=Beatrice|last3=Mosca|first3=Luciana|title=Bacterial vaginosis: a review on clinical trials with probiotics|url=http://www.newmicrobiologica.org/PUB/allegati_pdf/2013/3/229.pdf|journal=New Microbiologica|date=2013|volume=36|issue=3|pages=229–238|pmid=23912864}}</ref><ref>{{cite journal|last1=Mastromarino|first1=Paola|last2=Vitali|first2=Beatrice|last3=Mosca|first3=Luciana|title=Bacterial vaginosis: a review on clinical trials with probiotics|url=http://www.newmicrobiologica.org/PUB/allegati_pdf/2013/3/229.pdf|journal=New Microbiologica|date=2013|volume=36|issue=3|pages=229–238|pmid=23912864}}</ref><ref>{{cite journal|last1=Knoester|first1=M.|last2=Lashley|first2=L. E. E. L. O.|last3=Wessels|first3=E.|last4=Oepkes|first4=D.|last5=Kuijper|first5=E. J.|title=First Report of Atopobium vaginae Bacteremia with Fetal Loss after Chorionic Villus Sampling|journal=Journal of Clinical Microbiology|volume=49|issue=4|year=2011|pages=1684–1686|issn=0095-1137|doi=10.1128/JCM.01655-10|pmid=21289141|pmc=3122803}}</ref>
The lack of or the disruption of [[List of microbiota species of the lower reproductive tract of women|normal vaginal microbiota]] allows the proliferation of [[List of bacterial vaginosis microbiota|opportunistic microorganisms]] and will cause the opportunistic infection - [[bacterial vaginosis]].<ref name="AfricaNel2014">{{cite journal|last1=Africa|first1=Charlene|last2=Nel|first2=Janske|last3=Stemmet|first3=Megan|title=Anaerobes and Bacterial Vaginosis in Pregnancy: Virulence Factors Contributing to Vaginal Colonisation|journal=International Journal of Environmental Research and Public Health|volume=11|issue=7|year=2014|pages=6979–7000|issn=1660-4601|doi=10.3390/ijerph110706979|pmid=25014248|pmc=4113856}}</ref><ref name=Mastro2013>{{cite journal|last1=Mastromarino|first1=Paola|last2=Vitali|first2=Beatrice|last3=Mosca|first3=Luciana|title=Bacterial vaginosis: a review on clinical trials with probiotics|url=http://www.newmicrobiologica.org/PUB/allegati_pdf/2013/3/229.pdf|journal=New Microbiologica|date=2013|volume=36|issue=3|pages=229–238|pmid=23912864}}</ref><ref>{{cite journal|last1=Mastromarino|first1=Paola|last2=Vitali|first2=Beatrice|last3=Mosca|first3=Luciana|title=Bacterial vaginosis: a review on clinical trials with probiotics|url=http://www.newmicrobiologica.org/PUB/allegati_pdf/2013/3/229.pdf|journal=New Microbiologica|date=2013|volume=36|issue=3|pages=229–238|pmid=23912864}}</ref><ref>{{cite journal|last1=Knoester|first1=M.|last2=Lashley|first2=L. E. E. L. O.|last3=Wessels|first3=E.|last4=Oepkes|first4=D.|last5=Kuijper|first5=E. J.|title=First Report of Atopobium vaginae Bacteremia with Fetal Loss after Chorionic Villus Sampling|journal=Journal of Clinical Microbiology|volume=49|issue=4|year=2011|pages=1684–1686|issn=0095-1137|doi=10.1128/JCM.01655-10|pmid=21289141|pmc=3122803}}</ref>

== Opportunistic Infection and HIV/AIDS ==
HIV is a virus that targets [[T cell|T cells]] of the [[immune system]] and, as a result, HIV infection can lead to progressively worsening immunodeficiency, a condition ideal for the development of opportunistic infection.<ref>{{Cite journal|last=Doitsh|first=Gilad|last2=Greene|first2=Warner C.|date=2016-03-09|title=Dissecting How CD4 T Cells Are Lost During HIV Infection|url=https://linkinghub.elsevier.com/retrieve/pii/S1931312816300531|journal=Cell Host & Microbe|language=en|volume=19|issue=3|pages=280–291|doi=10.1016/j.chom.2016.02.012|pmc=PMC4835240|pmid=26962940}}</ref><ref>{{Cite journal|last=Fenwick|first=Craig|last2=Joo|first2=Victor|last3=Jacquier|first3=Patricia|last4=Noto|first4=Alessandra|last5=Banga|first5=Riddhima|last6=Perreau|first6=Matthieu|last7=Pantaleo|first7=Giuseppe|date=2019-12-27|title=T‐cell exhaustion in HIV infection|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/imr.12823|journal=Immunological Reviews|language=en|volume=292|issue=1|pages=149–163|doi=10.1111/imr.12823|issn=0105-2896|pmc=PMC7003858|pmid=31883174}}</ref> Because of this, respiratory and central nervous system opportunistic infections, including tuberculosis and meningitis, respectively, are associated with later-stage HIV infection, as are numerous other infectious pathologies.<ref>{{Cite journal|last=Bruchfeld|first=Judith|last2=Correia-Neves|first2=Margarida|last3=Källenius|first3=Gunilla|date=2015-02-26|title=Tuberculosis and HIV Coinfection: Table 1.|url=http://perspectivesinmedicine.cshlp.org/lookup/doi/10.1101/cshperspect.a017871|journal=Cold Spring Harbor Perspectives in Medicine|language=en|volume=5|issue=7|pages=a017871|doi=10.1101/cshperspect.a017871|issn=2157-1422|pmc=PMC4484961|pmid=25722472}}</ref><ref>{{Cite journal|last=Tenforde|first=Mark W|last2=Shapiro|first2=Adrienne E|last3=Rouse|first3=Benjamin|last4=Jarvis|first4=Joseph N|last5=Li|first5=Tianjing|last6=Eshun-Wilson|first6=Ingrid|last7=Ford|first7=Nathan|date=2018-07-25|editor-last=Cochrane Infectious Diseases Group|title=Treatment for HIV-associated cryptococcal meningitis|url=http://doi.wiley.com/10.1002/14651858.CD005647.pub3|journal=Cochrane Database of Systematic Reviews|language=en|doi=10.1002/14651858.CD005647.pub3|pmc=PMC6513250|pmid=30045416}}</ref> Kaposi’s sarcoma, a virally-associated cancer, has higher incidence rates in HIV-positive patients than in the general population. <ref>{{Cite journal|last=Rees|first=Chris A.|last2=Keating|first2=Elizabeth M.|last3=Lukolyo|first3=Heather|last4=Danysh|first4=Heather E.|last5=Scheurer|first5=Michael E.|last6=Mehta|first6=Parth S.|last7=Lubega|first7=Joseph|last8=Slone|first8=Jeremy S.|last9=The Baylor Pediatric HIV-Related Malignancy Consortium|date=2016-04-15|title=Mapping the Epidemiology of Kaposi Sarcoma and Non-Hodgkin Lymphoma Among Children in Sub-Saharan Africa: A Review: Pediatric HIV-Related Malignancies in Africa|url=http://doi.wiley.com/10.1002/pbc.26021|journal=Pediatric Blood & Cancer|language=en|volume=63|issue=8|pages=1325–1331|doi=10.1002/pbc.26021|pmc=PMC7340190|pmid=27082516}}</ref> As immune function declines and HIV-infection progresses to AIDS, individuals are at an increased risk of opportunistic infections that their immune systems are no longer capable of responding properly to. Because of this, opportunistic infections are a leading cause of HIV/AIDS-related deaths.<ref>{{Citation|last=Sadiq|first=Usama|title=Prevention Of Opportunistic Infections In HIV|date=2021|url=http://www.ncbi.nlm.nih.gov/books/NBK513345/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=30020717|access-date=2021-03-09|last2=Shrestha|first2=Utsav|last3=Guzman|first3=Nilmarie}}</ref>


== Prevention ==
== Prevention ==

Revision as of 02:28, 9 March 2021

Opportunistic infection
Chest X-ray of a patient who first had influenza and then developed Haemophilus influenzae pneumonia, presumably opportunistic
SpecialtyInfectious diseases Edit this on Wikidata

An opportunistic infection is an infection caused by pathogens (bacteria, fungi, parasites or viruses) that take advantage of an opportunity not normally available. These opportunities can stem from a variety of sources, such as a weakened immune system (as can occur in acquired immunodeficiency syndrome or when being treated with immunosuppressive drugs, as in cancer treatment),[1] an altered microbiome (such as a disruption in gut microbiota), or breached integumentary barriers (as in penetrating trauma). Many of these pathogens do not cause disease in a healthy host that has a non-compromised immune system, and can, in some cases, act as commensals until the balance of the immune system is disrupted.[2][3] Opportunistic infections can also be attributed to pathogens that cause mild illness in healthy individuals but lead to more serious illness when given the opportunity to take advantage of an immunocompromised host.[4]

Types of opportunistic infections

Further information: Immunodeficiency

A wide variety of pathogens are involved in opportunistic infection and can cause a similarly wide range in pathologies. A partial list of opportunistic pathogens and their associated presentations includes:

Bacteria

Fungi

Parasites

Viruses

Causes

Immunodeficiency or immunosuppression are characterized by the absence of or disruption in components of the immune system, leading to lower-than-normal levels of immune function and immunity against pathogens.[1] They can be caused by a variety of factors, including:

The lack of or the disruption of normal vaginal microbiota allows the proliferation of opportunistic microorganisms and will cause the opportunistic infection - bacterial vaginosis.[38][39][40][41]

Opportunistic Infection and HIV/AIDS

HIV is a virus that targets T cells of the immune system and, as a result, HIV infection can lead to progressively worsening immunodeficiency, a condition ideal for the development of opportunistic infection.[42][43] Because of this, respiratory and central nervous system opportunistic infections, including tuberculosis and meningitis, respectively, are associated with later-stage HIV infection, as are numerous other infectious pathologies.[44][45] Kaposi’s sarcoma, a virally-associated cancer, has higher incidence rates in HIV-positive patients than in the general population. [46] As immune function declines and HIV-infection progresses to AIDS, individuals are at an increased risk of opportunistic infections that their immune systems are no longer capable of responding properly to. Because of this, opportunistic infections are a leading cause of HIV/AIDS-related deaths.[47]

Prevention

Since opportunistic infections can cause severe disease, much emphasis is placed on measures to prevent infection. Such a strategy usually includes restoration of the immune system as soon as possible, avoiding exposures to infectious agents, and using antimicrobial medications ("prophylactic medications") directed against specific infections.[48]

Restoration of immune system

  • In patients with HIV, starting antiretroviral therapy is especially important for restoration of the immune system and reducing the incidence rate of opportunistic infections[49][50]
  • In patients undergoing chemotherapy, completion of and recovery from treatment is the primary method for immune system restoration. In a select subset of high risk patients, granulocyte colony stimulating factors (G-CSF) can be used to aid immune system recovery.[51][52]

Avoidance of infectious exposure

The following may be avoided as a preventative measure to reduce risk of infection:

Prophylactic medications

Individuals at higher risk are often prescribed prophylactic medication to prevent an infection from occurring. A patient's risk level for developing an opportunistic infection is approximated using the patient's CD4 T-cell count and sometimes other markers of susceptibility. Common prophylaxis treatments include the following:[53]

Infection When to Give Prophylaxis Agent
Pneumocystis jirovecii CD4 < 200 cells/mm3 or oropharyngeal candidasis (thrush) TMP-SMX
Toxoplasma gondii CD4 < 100 cells/mm3 and positive Toxoplasma gondii IgG immunoassay TMP-SMX
Mycobacterium avium complex CD4 < 50 Azithromycin

Treatment

Treatment depends on the type of opportunistic infection, but usually involves different antibiotics.

Veterinary treatment

Opportunistic infections caused by feline leukemia virus and feline immunodeficiency virus retroviral infections can be treated with lymphocyte T-cell immunomodulator.

Wikimedia Commons has media related to Opportunistic infections.

References

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