臨床小児科研究ジャーナル

CHILD WITH RECURRENT INFECTIONS

V. Gudichuttu

The lectin pathway is one of the three complement pathways in which patterns of carbohydrates on the surface of the pathogen is recognised leading to the activation of the complement cascade. A deficiency of which leads to recurrent upper and/or lower respiratory tract infections in children. Infants and children with this deficiency are usually susceptible to infections. Treatment is based on the severity of the illness. Apart from treating with regular antibiotics, children presented with severe infections might need prophylactic antibiotics. Common infections in MBL deficiency are due to viruses, e.g., influenza and bacteria, such as Pseudomonas aeruginosa and Staphylococcus aureus.

 

We are presenting an 18-month-old child who brought in with a recurrent history of respiratory/ear infections.A retrospective review of the child’s case notes and the investigations for his recurrent presentations to the hospital with respiratory and/or ear infections.He has persistently raised CRP. His basic immune functions and his immunoglobulins are normal. He was able to mount an adequate response to the vaccinations. He on few occasions needed antibiotics, and currently, taking only Azithromycin as a rescue drug rather than prophylaxis. The child has fewer infections ever since he stopped swimming and maintaining good hygiene.

 

Consider MBL in a child with persistently raised CRP and having features likely bacterial infection.

Practising hygiene.

Vaccines are safe to administer.

Treatment depends upon the severity of the infection but have a low threshold for early use of antibiotics (Macrolides).

Prophylactic antibiotics may be indicated in some cases.

Consider genetic studies.