Re-current infections can mean many things. They may be a normal part of early childhood, they may be occuring due to another medical condition, or more rarely they may reflect an underlying problem with the immune system.
At birth, the child's own immune system is immature, it has not previously come into contact with the vast number of germs in our environment. The number of infections a child may catch over the first few years of life can seem extraordinary. For example, a two year old may have an average of seven colds per year, some children may get ten to twelve per year. Cold symptoms can last up to eight days, with some lasting eighteen days. Experience an ear infection with up to one in four of their colds.
It's really easy to see why parents feel their children are sick all the time! Not all children catch the same number of infections, and even within families there are many reasons contributing to all of this.
Human Contact Children that attend Day Care or that are in contact with lots of other children, will usually catch more infections.
Passive Smoke Children who are born to mothers who smoked during their pregnancy could present with more chest infections in early childhood. Living in an environment with smoke exposure is also associated with a higher number of respiratory infections.
Nutrition Breast feeding gives some protection from respiratory and gastrointestinal infections early on.
AgeSome infections are more common at some ages, bronchiolitis is more common in children under 1 year of age.
Prematurity Some infants born early are more likely to have problems with infections, especially before the age of 1.
Allergy Hayfever and increased problems with ear infections and sinusitis, or eczema increases problems with skin infections.
Other Issues Such as re-current infections due to other medical conditions such as chronic chest or kidney disease may also occur. Immune Deficiency and Re-current Infection A re-current infection can be an important warning sign that the immune system is not working properly. But it is important to realise that re-current infection does not always mean there is an immune deficiency, and most people who meet some of the warning signs will not have a problem with their immune system.
Infections affecting infants are particularly important, as serious immune deficiencies usually become apparent during the first few years of life.
Persistant fungal infections of the skin or mouth, prolonged diarrhoea, or persistant cough are signs that need reviewing and consideration of an immune problem.
Full Medical History Details of the infections, frequency, severity and any complications. Patients with Immune deficiency are more llikely to develop infections inside the body, ie... lungs, bones, joints, liver, heart or brain. Sometimes an unusual germ could indicate an Immune deficiency.
Family History Details of previous similar problems within the family are vital.
Examination Including signs of chronic infection or other conditions that may cause re-current infection. Clinical situation (age, frequency, infection history and findings on the examination) may require a simple screening for possible Immune deficiency this may be undertaken in general practice or by referral to a specialist. Laboratory Diagnosis of Immunodeficiency Inexpensive screening tests can be undertaken in primary care. In general, a full blood count and an immunoglobulin level should be undertaken if a PID is suspected. More detailed laboratory testing is used to delineate the precise immunologic defect and should be undertaken in a tertiary referral centre. DNA diagnostic tests are available for many of these disorders. Indications for Referral Patients with an identified PID should be referred to a clinical immunology service. In general, suspicion of a PID should be aroused in patients suffering from recurrent or atypical infections. Others who have abnormal screening test should also be referred for further evaluation and investigation.