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Published on: September 7, 2022
Infectious pathogens in pediatric patients with primary immunodeficiencies
Shu-Hua Chang1, Yao-Hsu Yang, Bor-Luen Chiang
1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Background And Purpose:
Primary immunodeficiency diseases (PIDs) are rare disorders. Unusual infections often guide the initial investigation for immunodeficiency.
Methods:
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.
Results:
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.
Conclusions:
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.
Insights
Unusual infections like pneumonia are common in children with primary immunodeficiency diseases (PIDs). Early recognition of PIDs and rapid molecular diagnosis are crucial for timely intervention.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Primary immunodeficiency diseases (PIDs) are rare and often present with unusual infections.
- Identifying characteristic infection patterns is key for early PID investigation.
Purpose of the Study:
- To identify organisms causing predisposition to PIDs in children.
- To analyze infection patterns in pediatric PID patients.
Main Methods:
- Retrospective chart review of 92 children diagnosed with PIDs.
- Data collected from National Taiwan University Hospital (1984-2004).
Main Results:
- Pneumonia was the most frequent diagnosis across antibody, combined, and cellular deficiencies (76.5%-92%).
- Skin abscesses, pneumonia, and lymphadenitis were common in phagocyte defects.
- Organisms were identified in less than half of infection episodes; viral diagnosis was slow.
Conclusions:
- Early PID recognition depends on awareness of infection characteristics.
- Reliable and rapid molecular diagnostic methods are essential for immunocompromised patients.
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