The response of immunocompromised patients to infection is substantially modified from the classical "calor, dolor, rubor" reaction in immunocompetent patients.
The clinical signs may be subtle, and careful, repeated examination is thus esssential in immunocompromised patients.
A low grade fever may be the only indication of gram -ve sepsis, a thin serous exudate may suffice for pus and mild abdominal tenderness may replace frank peritonitis
Particular attention should be paid to the skin e.g. i.v. sites, the mouth - looking for dental sepsis or oral ulcers, the sinuses, the chest and the perianal area.
Serious infection may progress very rapidly and one should progress early to investigation and treatment.
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