Figure 738

Urinary tract infection (UTI) in an immunocompromised host. Pregnancy is associated with suppression of the host's immune response, in the form of reduced cytotoxic T-cell activity and reduced circulating immunoglobulin G (IgG) levels. Asymptomatic bacteriuria is common during pregnancy and represents a major risk of ascending infection complicated by acute pyelonephritis.

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FIGURE 7-38 (Continued)

Petersson and coworkers [12] recently demonstrated that the susceptibility of the pregnant woman to acute UTI is accompanied by reduced serum antibody activity (IgG, IgA, IgM), reduced urine antibody activity (IgG, IgA), and low interleukin 6 (IL-6) response, A-C, respectively.

The last may indicate that pregnant women have a generally reduced level of mucosal inflammation. These factors may be crucial for explaining the frequency and the severity of acute pyelonephritis during pregnancy. (From Petersson et al. [12]; with permission.)

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