Conditions associated with increased susceptibility to invasive pneumococcal disease

Underlying mechanism	Medical condition
Reduced capacity to make antibody to pneumococcal capsular polysaccharide	Genetically determined agammaglobulinemia
	Genetically determined hyporesponsiveness to pneumococcal polysaccharides
	Acquired ("common variable") hypogammaglobulinemia
	Selective IgG subclass deficiency
	Aging
	Diseases that specifically affect B-cell responses: Multiple myeloma Lymphoma HIV infection Chronic kidney or liver disease
	Diseases associated with loss of antibody: Nephrotic syndrome
	Immunosuppressive therapy: Drugs that inhibit TNF-alpha or interleukin activity Chemotherapy Radiation
Insufficient number of PMNs	Cyclic or drug-induced neutropenia
	Leukemia
	Aplastic anemia
Abnormal PMN function	Diabetes mellitus (poorly controlled)
	Chronic liver disease (also multifactorial)
	Chronic renal disease (also multifactorial)
	Glucocorticoids
Altered splenic function	Splenectomy
	Hyposplenism
	Hemoglobinopathy
Multifactorial (also poorly defined)	Malnutrition
	Alcohol use disorder
	Other chronic diseases
	Hospitalization
	Physical or emotional stress
	Systemic lupus erythematosus
Increased exposure	Daycare centers
	Military training camps
	Prisons
	Homeless shelters
Anatomic susceptibility	Cerebrospinal fluid leak
	Devices present in subarachnoid space
	Cochlear implant
	Inflammatory joint disease
	Active or recent respiratory viral infection

List of medical conditions that predispose a person to invasive pneumococcal disease, characterized by underlying mechanism for predisposition.

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