Approach to the Children with Recurrent Infections / 소아과

ABSTRACT

The major function of immune system is to protect infections. The immune systems are composed of innate and adaptive immunity. In adaptive immunity, the cellular and humoral components interact each other. Neonates and infants are infected frequently, because immune systems are naive and easy to expose to infectious agents. The complete history and physical examination is essential to evaluate the child with recurrent infections. The environmental risk factors of recurrent infections are day care center, cigarette smoke, and air pollution. The underlying diseases such as immunodeficiency, autoimmune diseases, allergy, and disorders of anatomy or physiology increase the susceptibility to infections. In immunodeficiency, infections are characterized by severe, chronic, recurrent, and unusual microbial agents infection. The defects of antibody production are susceptible to sinopulmonary bacterial infections. T cells defects are vulerable to numerous organisms such as virus, fungi, bacteria and etc. The screening tests for immune functions are the quantitative and qualitative measurements of each immune components. A complete blood count with white blood cell, differential, and platelet provide quantitative informations of immune components. Total complement and immunoglobulin levels represent the humoral component. Antibody levels of previously injected vaccines also provide informations of the antigen specific antibody immune responses. T cell and subsets count is quantitative measurement of cell mediated immunity. Delayed hypersensitivity skin test is a crude measurement of T cell function. The long term outcome of children with recurrent infections is completely dependent on the underlying diseases, the initial time of diagnosis and therapy, continued management, and genetic counscelling.