Hi, this is Tom, and in this episode I'm going to be going through recurrent infections in

children, and you can find notes at zero to finals.com and in the zero to finals pediatrics book,

and you can find flashcards and questions at members.0.0.0.com. So let's jump straight in.

It's normal for a healthy child to have 6 to 8 respiratory infections per year.

Frequent infections are common when starting nursery or school and during the winter months.

Most children with recurrent infections have a normal

immune system. Let's talk about the causes of recurrent infections. The most common cause is increased

exposure to infections, for example at nursery, school and with siblings. Key pathological causes of recurrent infections in children include primary immunodeficiency

disorders, for example, selective IGA deficiency or severe combined immunodeficiency.

Secondary immunodeficiency, for example, HIV infection,

malnutrition or immunosuppressant medications. Respiratory conditions, for example, asthma, cystic fibrosis,

primary ciliary dyskinesia, or bronchiakesis, anatomical abnormalities, for example, abnormalities

with the urinary tract, adenoid hypertrophy, or heart defects, neurological disorders which can

cause swallowing difficulties and aspiration, leading to aspiration pneumonia,

for example cerebral palsy, and hematological disorders, for example sickle cell disease or leukemia.

Let's talk about the features. Unusual features associated with recurrent infections that may suggest

underlying immunodeficiency or other pathology include chronic diarrhea since infancy,

poor growth or failure to thrive, recurrent severe infections, for example, infections requiring

IV antibiotics, persistent oral thrush after infancy, unusual organisms, for example, pneumocystice

geovecine pneumonia, recurrent infections across multiple different sites,

and a family history of immunodeficiency. Finally, let's talk about investigations. A specialist

referral is indicated where a pathological cause of recurrent infections is suspected.

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