Evaluation of the child with repeated infections

The workup of a patient with suspected immune deficiency can be initiated by the primary-care physician utilizing readily available diagnostic tests (Table 1). Carefully obtained history and physical examination are crucial and will identify the patient at risk. In almost all cases, simple procedures performed by the physician in his office with routine laboratory assistance will enable him to establish a provisional diagnosis. Referral may then be made to a specialized center for more elaborate diagnostic procedures, confirmation of diagnosis, and definitive therapy.