Does Immunodeficiency Matter in ENT

Primary immunodeficiencies (PID) are found in around 1 in 10,000 American children and 1 in 20,000 children in Europe. Given the difficulty in recognising the condition, clinicians need to be alert to the possibility of PID, if they are to identify it at an early stage. Groups representing both patients and their families have identified a 10-point checklist of warning signs showing PID. The signs include the following: (1) at least four separate ear infections within 12 months; (2) at least two grave sinusal infections within 12 months; (3) antibiotic treatment by mouth with a duration of 2 months minimum, with minimal benefit; (4) pneumonia at least twice within 12 months; (5) an infant fails to achieve expected growth; (6) a deep cutaneous abscess, or abscess within an organ, that recurs; (7) oral candidiasis that persists or mucocutaneous fungal infections; (8) only when antibiotics are given parenterally do they resolve infections; (9) firmly entrenched infection, e.g. septicaemia, on at least two occasions; and (10) PID in a genetic relative. In this chapter, immunodeficiency and ENT diseases are discussed in detail.