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  • The Immunodeficient Child: Primary Secondary

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    Timir Sahu
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    The document discusses evaluating immunodeficient children, including taking a history of infections, failure to thrive, drug use, immunizations, and family history. The examination looks for signs of infection, malnutrition, lymphadenopathy, hepatosplenomegaly, and oral/genital issues. Investigations include blood tests, urine tests, chest x-rays, and abdominal ultrasounds to check for infections, antibodies, HIV, and organ abnormalities. Differential diagnoses include primary immunodeficiencies like antibody deficiencies or complement deficiencies, and secondary causes such as HIV, drugs, diabetes, malnutrition, and anatomical defects.

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    IMMUNODEFICIENT CHILD

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    The document discusses evaluating immunodeficient children, including taking a history of infections, failure to thrive, drug use, immunizations, and family history. The examination looks for signs of infection, malnutrition, lymphadenopathy, hepatosplenomegaly, and oral/genital issues. Investigations include blood tests, urine tests, chest x-rays, and abdominal ultrasounds to check for infections, antibodies, HIV, and organ abnormalities. Differential diagnoses include primary immunodeficiencies like antibody deficiencies or complement deficiencies, and secondary causes such as HIV, drugs, diabetes, malnutrition, and anatomical defects.

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    8 views1 page

    The Immunodeficient Child: Primary Secondary

    Uploaded by

    Timir Sahu
    The document discusses evaluating immunodeficient children, including taking a history of infections, failure to thrive, drug use, immunizations, and family history. The examination looks for signs of infection, malnutrition, lymphadenopathy, hepatosplenomegaly, and oral/genital issues. Investigations include blood tests, urine tests, chest x-rays, and abdominal ultrasounds to check for infections, antibodies, HIV, and organ abnormalities. Differential diagnoses include primary immunodeficiencies like antibody deficiencies or complement deficiencies, and secondary causes such as HIV, drugs, diabetes, malnutrition, and anatomical defects.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 1

    THE IMMUNODEFICIENT CHILD

    HISTORY
    1. History of – repeated chest infections/ skin infections/ chronic diarrhea/ candidiasis/ extensive
    dental caries/ long standing or relapsing fever/ chronic ear discharge
    2. Failure to thrive
    3. Drug history – for steroids/ immunosuppressive drugs
    4. Immunization history
    5. Family history – Diabetes/ TB/ HIV/
    6.
    EXAMINATION
    1. General examination – pallor/ edema/ hair growth/ clubbing/
    2. Growth charting – weight and height
    3. Lymphadenopathy/ hepatomegaly/ splenomegaly
    4. Chest – crepts/ rhonchi/ dullness
    5. Oral examination – caries/ candidiasis/ tonsillitis
    6. Genital – candidiasis/ any skin excoriation/ anal papillomas
    7.
    INVESTIGATIONS
    1. CBC, CRP, ESR. Peripheral smear
    2. Fasting blood sugar
    3. HIV
    4. Urine – RE/ME, culture
    5. CXR
    6. USG whole abdomen – to look for any evidence of intraabdominal abscess, mesenteric adenitis,
    thickening of ileum

    DIFFERENTIAL DIAGNOSIS

    Consider immunodeficiency in all children with unusual, severe, persistent and recurrent infections.

    Primary Secondary
    Antibody deficiency HIV
    Complement deficiency Immunosuppressive drugs
    Neutropenia Diabetes mellitus
    Chronic granulomatous disease Malnutrition
    Cellular immunodeficiency Hyposplenism
    Ataxia telangiectasia Cystic fibrosis
    Anatomical abnormalities – skull base defect

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