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VERIFIED CONTENTAuthor: lek. Katarzyna Banaszczyk

Frequent infections, especially of the respiratory tract, are a real bane for many parents. How many times in a year can a child get sick? When should you worry and deepen the diagnosis? What is the situation for adults?

How many times a year can a child catch a cold?

Many parents feel that their child is constantly ill. This mainly applies to nursery and kindergarten children. This is quite normal, the baby comes into contact with new germs and can get sick up to 8-10 times a year.

If these are typical colds and the child recovers and does not have any disturbing symptoms in the period between infections, this does not indicate a suspicion of immunodeficiency. With age, the number of infections decreases and the child becomes ill less and less often.

The immune system develops with age and learns to respond to new microorganisms - human immunity is built up.

Frequent infections - when should the diagnostics be deepened?

It is worth reading some guidelines here, which indicate what types of infectious diseases and how many of them per year should arouse our concern and make us visit a specialist.

These symptoms are called alarm symptoms, and they may be symptoms of an abnormality called immunodeficiency. In children, in the vast majority of cases, we will suspect a primary immunodeficiency, i.e. one that is inherited.

The alarm symptoms include such clinical situations as:

  • ear infections - at least four or more such infections a year, one or two ear infections is definitely not a cause for concern,
  • use of antibiotic therapy without improvement for two months, when the antibiotic is used as indicated - i.e. for a bacterial infection,
  • at least two or more sinusitis in a year,
  • pneumonia - same as with sinusitis, two or more pneumonia per year should cause anxiety,
  • occurring deep skin abscesses, organ abscesses - an abscess is a well-delimited focus of pus occurring within tissues or organsinternal,
  • abnormal weight gain,
  • the need to use long-term intravenous antibiotics during an infection,
  • chronic oral mycosis - this applies to children over 1 year of age - infants (i.e. children under the age of one) often have oral infections and this is not considered to be an immunodeficiency,
  • diagnosis of immunodeficiency in someone in the child's family, unexplained deaths of children in the family,
  • developing a severe infection - such as sepsis, severe skin infection, osteitis, encephalitis - such a severe infection must occur at least twice in a lifetime to be considered an alarm symptom.

What to do when symptoms are alarming?

In the event of the above-mentioned alarming symptoms (one such symptom is enough), it is definitely worth going to a consultation with a doctor who, after an interview, will decide on further diagnostic steps. In the case of children, the clinics that carry out diagnostics in this direction are immunodeficiency clinics. There, specialist doctors can refer the child for tests for possible immune disorders.

A family doctor or a pediatrician in a primary he alth care clinic do not have the possibility to refer a child for specialist tests in this field, but after examination and an interview, they may decide to consult such a clinic. A referral to an immunodeficiency clinic is required and can be obtained from your GP or pediatrician.

Primary and Secondary Immunodeficiencies

Immunity deficiencies are divided into primary and secondary. Primary immunodeficiencies are congenital conditions. They can result, among others, from impaired production of antibodies - this mechanism occurs in the most common primary immunodeficiency disease, which is IgA deficiency.

This condition is often asymptomatic and can accompany other abnormalities such as celiac disease, type 1 diabetes, juvenile idiopathic arthritis, and inflammatory bowel diseases such as ulcerative colitis or Crohn's disease.

Other, more symptomatic diseases, belonging to the primary immunodeficiency are:

  • common variable immunodeficiency,
  • a condition resulting from a disturbed cellular response,
  • diseases resulting from phagocytosis disorders.

Secondary immunodeficiencies are much more often diagnosed in adults. They are a consequence of other disease states- they are not congenital. The causes of secondary immune disorders that are worth mentioning here include:

  • use of drugs that suppress the immune system, i.e. the so-called immunosuppressants - these include, among others, steroids, cyclosporine, methotrexate, many drugs used in cancer chemotherapy,
  • infections, viral and bacterial infections - HIV, measles virus, HSV, EBV, mycobacterial and parasitic infections - e.g. malaria,
  • cancer, especially leukemias and lymphomas,
  • chronic diseases such as diabetes, kidney failure, malnutrition, liver failure, cirrhosis,
  • an autoimmune condition such as rheumatoid arthritis,
  • condition after organ transplantation - transplant patients must use immunosuppressive drugs to prevent rejection, which unfortunately adversely affects immunity,
  • exposure to ionizing radiation and certain chemical compounds,
  • protein deficiency - e.g. loss from burns,
  • to lower immunityo also predisposes chronic stress - when the level of cortisol in our body is constantly elevated - it must be noted that cortisol is a steroid hormone, so it will affect our body in a similar way to the above-mentioned steroid drugs,
  • malfunction of the spleen, lack of spleen - this organ is responsible for the destruction of enveloped bacteria, which include, among others, pneumococci, therefore its absence or malfunction is associated with states of reduced immunity.

When should secondary immunodeficiency be suspected?

Disorders of many body systems may be associated with the presence of secondary immunodeficiency. With regard to the individual systems, it looks like this:

  • in the case of the respiratory system, our attention should be drawn to: bronchiectasis, as well as the diagnosis of sarcoidosis or tuberculosis,
  • in the case of the digestive system - chronic, recurrent diarrhea, significant, unplanned weight loss, ulcerative colitis, celiac disease, recurrent bacterial and parasitic diseases of the digestive system: salmonellosis or giardiasis,
  • in relation to ENT diseases - frequent occurrence of otitis media, recurrent mycoses of the outer ear,
  • in the case of the osteoarticular system - recurrent arthritis or cellulitis,
  • in the case of the nervous system - encephalitis, toxoplasmosis, brain lymphomas, aespecially cryptococcal meningitis,
  • in relation to the skin: recurrent, difficult to treat abscesses, as well as Kaposi's sarcoma - an indicator tumor in AIDS, viral warts that do not respond to treatment, alopecia of unknown cause, and recurrent shingles.

Immunodeficiency diagnosis

If an immunodeficiency is suspected, it is worth performing laboratory tests to confirm or rule out such a diagnosis. First-line testing, or screening for immunodeficiency, mainly includes:

  • immunoglobulin levels (IgG, IgM, IgA, IgE),
  • determination of the titer of specific antibodies directed against the antigens of childhood vaccines,
  • determination of the number of B cells by flow cytometry.

Frequent illness is not always immunodeficiency

What other situations can make a child or adult sick often? It is worth thinking not only about immunodeficiencies, but also about:

  • allergy - a chronic runny nose, which is related to the pollen season and improves after typical antiallergic treatment (antihistamines), should rather encourage us to visit an allergist, as does recurrent conjunctivitis,
  • asthma - chronic cough, wheezing, in older children, shortness of breath, chest tightness, dry paroxysmal cough, decreased exercise tolerance - these symptoms should prompt pulmonary diagnosis for asthma,
  • iron deficiency, vitamin D deficiency - it is worth doing basic tests to rule out deficiency causes of frequent infections. Particular attention should be paid to the problem of vitamin D deficiency, which is common in our latitude, and remember to supplement it regularly.

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