Infectious pathogens in pediatric patients with primary immunodeficiencies

Shu-Hua Chang, Yao-Hsu Yang, Bor-Luen Chiang
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan

Received: June 30, 2005    Revised: March 24, 2006    Accepted: March 30, 2006   

Dr. Bor-Luen Chiang, MD, PhD, Department of Pediatrics, National Taiwan University Hospital, No.7, Chung Shan South Road, Taipei 100, Taiwan. E-mail: gicmbor@ha.mc.ntu.edu.tw This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 

Primary immunodeficiency diseases (PIDs) are rare disorders. Unusual infections often guide the initial investigation for immunodeficiency.

 

In order to ascertain the organisms that lead to a predisposition for PIDs, we reviewed the charts of 92 children diagnosed with PIDs at the National Taiwan University Hospital between March 1984 and March 2004.

 

Pneumonia was diagnosed in 92%, 81%, and 76.5% of patients with antibody, combined, and cellular deficiencies, respectively. Other major illnesses were similar in the 3 groups and included bronchiolitis, acute gastroenteritis, otitis media, and bacteremia. Skin abscess, pneumonia, and lymphadenitis (54.5%, 45%, and 27% of cases, respectively) were the most common infections in patients with phagocyte defects. Organisms were speciated in only 44.8% of infection episodes. Most viral infections were diagnosed by traditional and time-consuming viral culture. Prophylactic antibiotics were prescribed to 9 out of the 92 patients with PIDs.

 

Early recognition of PIDs requires that practitioners be aware of the infection characteristics, and subsequent reliable and rapid molecular diagnosis are needed in such immunocompromised patients.

 

Etiology, infection, immunologic deficiency syndromes, phagocytes

 

J Microbiol Immunol Infect 2006;39:503-515