The Patient with ‘Too Many Infections’

Diagnostic Approach
  • Mary E. Paul
  • William T. Shearer
Part of the Current Clinical Practice book series (CCP)


The cornerstone of the practice of primary care medicine is the ability to recognize unusual or distinct manifestations of disease and to separate these from those that are routine or expected. Immunodeficiency should be suspected immediately when a patient has an opportunistic infection or the features of one of the immunodeficiency syndromes. However, the primary care provider must more commonly grapple with the question, How many routine infections are too many? Answering this question involves the consideration of factors that influence immune function such as environment and age. This chapter provides an overview of the immune deficiency disorders, the differential diagnosis to be considered for the patient with recurrent infection and a diagnostic approach for the patient suspected of having immunodeficiency.


Human Immunodeficiency Virus Infection Chronic Granulomatous Disease Purine Nucleoside Phosphorylase Chronic Granulomatous Disease Patient Severe Combine Immunodeficiency Disease 
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Suggested Reading

  1. Noroski LM, Shearer WT. Short analytical review: screening for primary immunodeficiences in the clinical immunology laboratory. Clin Immunol Immunopath 1998; 86: 237–245.CrossRefGoogle Scholar
  2. Paul ME, Shearer WT. The child with recurrent infection. In: Kelly KK, ed. Immunol Allergy Clin North Am, 1999.Google Scholar
  3. Puck JM. Primary immunodeficiency diseases. JAMA 1997; 278: 1835–1841.PubMedCrossRefGoogle Scholar
  4. Shearer WT, Fleisher TA. The immune system. In: Middleton E, Reed CE, Ellis EF, Adkinson NF, Yunginger JW, Busse WW, eds. Allergy: Principles and Practice, 5th ed., St. Louis: Mosby, pp. 1–13, 1998.Google Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Mary E. Paul
  • William T. Shearer

There are no affiliations available

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