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APPROACH TO PRIMARY IMMUNODEFICIENCY

Warning Signs for Immune Deficiency. Consider immune deficiency when two or more of the following are present (data from Jeffrey Modell Foundation).

  • Recurrent otitis (≥8 episodes), sinusitis (≥2 episodes), or pneumonia (≥2 episodes) in 1 year (from Jeffrey Modell Foundation)

  • Two or more invasive infections (meningitis, sepsis, osteomyelitis, etc.)

  • Recurrent deep skin or organ abscesses

  • Infections with unusual or opportunistic organisms

  • Failure to thrive

  • Persistent thrush in mouth or elsewhere on skin after 1 year of age

  • Need for intravenous antibiotics to clear common infections

  • Family history of immunodeficiency

MAJOR CATEGORIES

The major categories of primary immune deficiencies reflect the various arms of the immune system (Tables 14-1 and 14-2).

TABLE 14-1

Classification of Primary Immune Deficiencies

TABLE 14-2

Features and Diagnostic Approach for Primary Immune Deficiencies

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