Published 12 November 2009, doi:10.1136/bmj.b4118
Cite this as: BMJ 2009;339:b4118

Practice

Rational Testing

Investigating recurrent respiratory infections in primary care

Philip Wood, consultant immunologist1, Daniel Peckham, consultant respiratory physician2

1 Department of Clinical Immunology, St James’s University Hospital, Leeds, LS9 7TF, 2 Department of Respiratory Medicine, St James’s University Hospital

Correspondence to: P Wood philip.wood@leedsth.nhs.uk

Repeated respiratory tract infections in an apparently otherwise well young person should raise suspicions of underlying immunodeficiency or other respiratory disease

The first 150 words of the full text of this article appear below.

A 29 year old man presents to the surgery with a third episode of respiratory tract infection in three months, having had one admission to hospital with proved pneumococcal pneumonia five months ago. He is a previously well non-smoker who does not have asthma, any previous diagnosed chronic medical condition, or recent history of foreign travel.

He has no weight loss or night sweats. On examination he has bilateral basal crackles in the lungs, normal tympanic membranes, no facial tenderness, and no lymphadenopathy or splenomegaly. A full blood count is normal; random and fasting blood glucose, urea, creatinine, and liver enzymes are all normal, and urinalysis is negative for blood and protein. Sputum culture identifies the presence of Haemophilus influenzae. A chest radiograph is reported as normal.

In 2007 the reported prevalence for acute respiratory infections in the United Kingdom was 1599/10 000 population, with peaks in early childhood . . . [Full text of this article]


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This article has been cited by other articles:

  • Collini, P., Greig, J. (2009). HIV needs to be excluded. BMJ 339: b5135-b5135 [Full text]  

Rapid Responses:

Read all Rapid Responses

HIV is a very relevant cause of recurrent respiratory bacterial infection and should be excluded
Paul Collini, et al.
bmj.com, 18 Nov 2009 [Full text]
A clear indication for HIV testing.
Morgan Evans
bmj.com, 23 Nov 2009 [Full text]
Re: A clear indication for HIV testing
Dr Viera Scheibner
bmj.com, 24 Nov 2009 [Full text]
Always test for HIV as part of investigation of recurrent respiratory infection
Margaret D Portman, et al.
bmj.com, 30 Nov 2009 [Full text]
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