Recurrent infections in children Flashcards
When do investigate recurrent infections in children?
It can be difficult to know when to investigate further for recurrent infections in children. It is normal for a healthy child to have 4 – 8 respiratory infections per year. When starting nursery or school and during winter months children are likely to pick up recurrent infections.
Most children with recurrent infections have a normal immune system. Other features associated with recurrent infections may make you consider investigating further for immunodeficiency and other pathology. Children with these features should be referred to a specialist for further assessment.
Chronic diarrhoea since infancy
Failure to thrive
Appearing unusually well with quite a severe infection, for example afebrile with a large pneumonia
Significantly more infections than expected, particularly bacterial lower respiratory tract infections
Unusual or persistent infections such as cytomegalovirus, candida and pneumocystis jiroveci
Investigations for recurrent infections?
The choice of investigations will be guided by a full history and examination.
Full blood count: low neutrophils suggest a phagocytic disorder and low lymphocytes suggest a T cell disorder
Immunoglobulins: abnormalities suggest a B cell disorders
Complement proteins: abnormalities suggest a complement disorder
Antibody responses to vaccines, specifically pneumococcal and haemophilus vaccines
HIV test if clinically relevant
Chest xray for scarring from previous chest infections
Sweat test for cystic fibrosis
CT chest for bronchiectasis
