Inflammatory diseases, such as arthritis, inflammatory bowel disease, pyoderma granuloma, and connective tissue disorders are also seen with increased frequency. Defects in immunoglobulins and/or complement proteins — Recurrent sinopulmonary infections, chronic gastrointestinal infections, bacteremia, and/or meningitis are associated with defects in immunoglobulins and/or complement proteins. ●A secondary immunodeficiency, including HIV infection, hemoglobinopathy, multiple myeloma, or chronic lymphocytic leukemia, can lead to recurrent pneumonia . Granulocyte (neutrophil) defects — Recurrent invasive skin and soft tissue infections, especially focal abscesses requiring incision and drainage, are associated with granulocyte (neutrophil) defects. Common pathogens include the encapsulated bacteria, S. pneumoniae, H. influenzae type b, and N. meningitidis, as well as Giardia, Cryptosporidia, andCampylobacter. The initial approach to an adult patient with recurrent infections is discussed here, with a discussion of the nonimmunologic disorders that should be considered in the evaluation of recurrent infection at specific anatomic sites and a brief overview of immunodeficiency in adults. 2020; 130: 373-381. — The clinical history should include a careful review of past medical problems and their treatments, surgeries, accidental injuries, and medications. In these situations, recurrent infection is limited to the neck, axilla, groin, umbilicus, or site of previous trauma, and there is no need to suspect a generalized susceptibility to infection, ●Multiple or recurrent abscesses in a variety of locations may be the result of autoinoculation in the setting of drug abuse (subcutaneous drug injection or "skin-popping") or Munchausen syndrome, Qualitative granulocyte disorders rarely present with recurrent abscesses in adults, but acquired quantitative granulocyte disorders (myelofibrosis and other causes of progressive marrow failure) may develop in this population, ●The epidemic of community-acquired methicillin-resistant. For example, the majority of patients who have intact immune systems may still contract multiple upper respiratory infections each year, usually of viral origin. Noninfectious manifestations of immunodeficiency — In addition to infections, many immune disorders are associated with autoimmune disease and a higher risk of malignancies. A bony cranial defect can usually be detected by high-resolution computed tomography (HRCT) scanning . 2018;13(3):e0194858. ●Referral to a variety of different specialists may be needed, depending upon the expertise and interest of the generalist, as well as the availability of specialists. — The physical examination of a patient with a history of recurrent infections may reveal anatomic abnormalities or signs and stigmata of significant underlying disorders (eg, venous insufficiency). Most children who have repeated infections donât have any serious problems and grow up to be healthy adults. In some individuals, beta-lactamase production by oral flora is associated with penicillin failure . HIV testing, hemoglobin electrophoresis, and serum and urine electrophoresis for multiple myeloma may be indicated. Recurrent herpes simplex — Patients with frequent and/or severe oral, cutaneous, or genital herpes infections are often referred for formal infectious disease consultation. However, secondary immune defects due to other medical disorders are sometimes identified, while primary immune defects presenting in adults are rare. The immune system is smart and has the ability to learn the “face” of a germ and remember it. To the Point ●Older men can develop recurrent urinary tract infections with increasing frequency, largely due to obstructive and/or neurogenic abnormalities. Like any part of your body, you can get infections and illnesses that can affect your teeth, gums, and tongue. — Isolated recurrent urinary tract infections, in the absence of infections in other organ systems, are not a typical presentation of immunodeficiency. It is the only skin-lined cul-de-sac in the human body. HIV testing, hemoglobin electrophoresis, and serum and urine electrophoresis for multiple myeloma may be indicated. This has been best described after saphenous venectomy for coronary artery bypass graft surgery. Severe periodontitis — Adults with diabetes mellitus have an increased risk of periodontitis. Patients with tracheal disorders, such as tracheobronchomegaly or tracheomalacia, may have recurrent infections in a limited or more generalized pattern. The etiology and subsequent approach varies according to the type and pattern of infections present. "This is an area in which women can experiment and find which solution works for them," Dr. Gupta says. The external auditory canal is warm, dark and prone to becoming moist, making it an excellent environment for bacterial and fungal growth. Although most brain abscesses result from direct extension from adjacent foci of infection, such as sinusitis or mastoiditis, a variety of remote abnormalities may be important in selected patients. In this episode, Vivian Hernandez-Trujillo, MD, FAAAAI, gives a primer on evaluating children who seem to be sick more than the average child. ●Chronic diarrhea with weight loss, especially due to campylobacter or cryptosporidiosis. In adults, recurrent infections are usually due to an anatomic lesion, a functional disorder, or to a secondary cause of immunosuppression. Severe and/or recurrent febrile illnesses or infections or childhood deaths in relatives may suggest an X-linked or autosomal recessive immune disorder. Bacterial meningitis â The epidemiology of recurrent bacterial meningitis was evaluated in a review of 493 episodes in 445 adults seen at a single center in Boston from 1962 to 1988  . 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