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The Immunocompromised Host Quiz
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Which combination of infection features should prompt a clinician to suspect an underlying immunodeficiency?
- A Persistent, unusual, or recurrent infections You picked ✓
- B Severe infections occurring only in early childhood You picked ✕
- C A single severe infection with a common pathogen You picked ✕
- D Infections confined to a single anatomical site You picked ✕
- E Any infection requiring hospital admission You picked ✕
Correct!
Incorrect
The answer is A: Persistent, unusual, or recurrent infections
Explanation
Why A is correct
See When should we suspect an Immunodeficiency?. Option A is correct. An immunodeficiency is a fault in one or more parts of the immune system, so the body cannot respond to infection properly. It can be primary (present from birth because of a gene defect) or secondary (acquired, for example from a disease or treatment). The clue is the pattern of infection, summarised by the mnemonic SPUR: Severe (could be life-threatening if untreated), Persistent (does not respond properly to usual treatment), Unusual (an odd site or microbe, such as a deep tissue infection or an opportunistic organism, meaning a microbe that rarely harms people with healthy immunity) and Recurrent (more frequent than expected for a person with healthy immunity). Primary immunodeficiency is often missed: diagnosis may be delayed for years and many patients are diagnosed as adults, leaving permanent damage. If SPUR features are present, check for a secondary cause first, then arrange a full blood count and tests of antibody, T-cell, phagocyte and complement function. Remember too that some patients present with autoimmunity, cancer or inflammation instead of infection.
- Definition: an immunodeficiency is a fault in the immune system, either primary (from birth) or secondary (acquired).
- Pattern: the mnemonic SPUR stands for severe, persistent, unusual and recurrent infections.
- Next step: check for a secondary cause first, then test antibody, T-cell, phagocyte and complement function.
Why the other options are incorrect
- B. Severe infections occurring only in early childhood: Severe infections that occur only in early childhood would be common and are often normal as the immune system matures. Many primary immunodeficiencies also present later, and some are diagnosed in adulthood. Your answer
- C. A single severe infection with a common pathogen: A single severe infection with a common pathogen can occur in an otherwise healthy person and does not demonstrate the persistent, unusual or recurrent pattern that suggests immunodeficiency. Severity alone is less specific than the overall pattern of infections. Your answer
- D. Infections confined to a single anatomical site: Infections confined to one anatomical site usually point to a local problem such as an anatomical abnormality, foreign body or breached skin barrier, rather than a systemic immune defect. Recurrent infections at the same site should prompt a search for that local cause first. Your answer
- E. Any infection requiring hospital admission: Many ordinary infections need admission, for example in frail or very young patients, so admission alone does not suggest immunodeficiency. The pattern of infection matters more than the setting of care. Your answer
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More questions from this set. Start the quiz to answer them and see each explanation.
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1
Which primary immunodeficiency is characterised by absent or extremely few mature B cells and a profound lack of all antibody classes?
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2
A 28-year-old woman had a splenectomy after a road traffic collision. She is reviewed in primary care several months later to discuss long-term health risks. Which immune function is most directly impaired by the loss of her spleen?
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