Pediatric Immunodeficiency (Non-HIV)
Diagnosis/Definition
Patients with humoral, cellular or combined immunodeficiency that is not due to HIV infection.
Initial Diagnosis and Management
- A child should be suspected of immunodeficiency if he/she has more than 2 serious systemic infections with common bacterial pathogens (e.g., meningitis, sepsis, and overwhelming pneumonia), more than eight/year significant upper respiratory tract infections (e.g., otitis/sinusitis), recurrent soft tissue abscesses/infections, or any infection with an opportunistic or unusual pathogen.
- Children should have a thorough history and physical performed by the primary care provider to exclude anatomical causes, underlying chronic disease, or inaccurate history.
Ongoing Management and Objectives
- CBC and differential
- HIV serology
- Quantitative immunoglobulin panel
Indications for Specialty Care Referral
If the history and physical taken by the primary care provider is suggestive of an immunodeficiency, and underlying causes are excluded, the patient should be referred to the Pediatric Infectious Disease (I.D.) clinic for an intake evaluation on a routine basis.
Criteria for Return to Primary Care
If the patient is determined not to be immunodeficient after consultation by Pediatric I.D., then he/she will be returned to primary care without any further follow-up.
If an immunodeficiency is identified, appropriate follow-up and management of the disorder will be provided by Pediatric I.D., and routine care will remain with the primary care provider.
