Recurrent infections in a five year old boy

Children are prone to develop recurrent illness in the form of upper respiratory tract infections, gastroenteritis, pustulosis and otitis media owing to developing immunity and environmental exposures. Majority of such children improve on symptomatic treatment. However, few of them might develop severe life threatening infections affecting vital organs. Primary immunodeficiency is an entity in which children develop recurrent infection due to defect in the development of immune system. This may affect plasma cells, T lymphocytes, natural killer cells or peripherally circulating leucocytes. We present a 5 year old male child with such diagnosis. A five year old boy was admitted with history of repeated infections since one year of age. His serum IgA, IgG and IgM levels were markedly decreased. Flow cytometry showed absence of B cells. He was started on intravenous immunoglobulin 10 gm every four weeks following which there was marked reduction in intercurrent infections. Primary immunodeficiency should always be suspected in differential diagnosis if history of repeated infections exist.