akinohanayuki ブログ

学位を持っても、センスのない、感染制御専門薬剤師のブログ.  I have Ph.D. but less sense ID pharmacist.

recurrent infections (adults)

何かが変だよ recurrent infections 
基本から再確認 recurrent infections 
 
私が、臨床で良く遭遇するのは
グラム陽性球菌の菌血症治療期間が不十分で、どこかに膿瘍等生じ、再燃するケースです。
 
よって、非常に基礎的な内容から見直しが必要ですね。
 
UpToDate 

 

The vast majority of adults presenting with recurrent infections, especially localized to one organ system, have an anatomic abnormality or underlying condition that predisposes to infections, (such as allergic rhinitis causing recurrent sinusitis or saphenous venectomy causing recurrent cellulitis) rather than an immune defect.


When an immune defect is suspected in an adult, secondary causes of immunodeficiency (eg, diabetes, immune-altering medications) are more common than primary immunodeficiencies.
 
Primary immunodeficiency occasionally presents for the first time in adulthood. Affected patients may also have autoimmune disease and suffer higher rates of malignancies, as these disorders are also manifestations of abnormal immune function. A history of one or more of these types of disorders in a patient with recurrent infections should raise suspicion of an underlying immunodeficiency.
 
Referral to a variety of different specialists may be needed, depending upon the expertise and interest of the generalist, as well as the availability of specialists. Referral to an allergist/immunologist is best pursued before extensive immunologic testing is initiated.
 
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