Recurrent infections

Question 1

up to _ URTI a year in young children is normal

Answer 1

8

Question 2

10 Warning signs of primary immunodeficiency

Answer 2

four or more new ear infections within 1 year
two or more serious sinus infections within 1 year
two or more months on antibiotics with little effect
two or more pneumonias within 1 year
failure of an infant to gain weight or grow normally
recurrent deep skin or organ abscesses
persistent thrush in mouth or fungal infection on skin
need for IV antibiotics to clear infections
two or more deep seated infections including septicaemia
a family history of PI

Question 3

primary immunodeficiency

Answer 3

a group of diverse illnesses that as a result of one or more abnormalities of the IS increase susceptibility to infection - mostly in males - X-linked disorders

Question 4

Pyrexia of unknown origin

Answer 4

temperature of more than 38.3 in whom no specific diagnosis after two outpatient visits or three days in hospital
NB to ask travel history - malaria

Question 5

Fever without localising signs

Answer 5

well looking older than 3m
> 39 = investigate and empiric outpatient AB treatment
< 39 = observed return symptoms develop

well looking younger than 3m
> 39 = admit and investigate
< 39 = blood count and urine examination - if normal to return if symptoms develop

ill and toxic 
urgent admission 
investigate 
- blood culture 
- urine culture 
- FBC 
- CSF examination recommended 
- CXR 
Treat