However, secondary immune defects due to other medical disorders are sometimes identified, while primary immune defects presenting in adults are rare. Some immunodeficiencies are also associated with higher rates of allergic disease, which is another manifestation of immune dysregulation. These diseases affect thousands of infants, children and adults in the United States. Urinary tract infections remain a significant cause of morbidity in all age groups. Investigation of these individuals for underlying T or natural killer (NK) cell dysfunction is indicated, although in many instances the underlying immunologic disorders are known at the time of presentation with severe herpes simplex. Referral to an allergist/immunologist or infectious disease specialist would be prudent to help guide further testing. Tissue and organ focal infections (phlegmon, granuloma, or abscess) also occur. ●Peripheral arterial disease with ischemia is associated with an increased risk of recurrent skin infection in the affected limbs. Defects in cell-mediated immunity — Progressive infections with ordinarily "benign" viruses, opportunistic intracellular pathogens, or fungi suggest defective cell-mediated immunity, particularly defects of T cells. "This is an area in which women can experiment and find which solution works for them," Dr. Gupta says. Chronic sinusitis occurs when the spaces inside your nose and head (sinuses) are swollen and inflamed for three months or longer, despite treatment.This common condition interferes with the way mucus normally drains, and makes your nose stuffy. It is helpful to consider the following broad categories of etiologies when evaluating an adult with recurrent infections: "Warning signs" of primary immunodeficiency in adults have been developed to help patients and clinicians recognize excessive infections . In cases where HSV-2 does not appear to be the cause of illness based on negative cultures, the absence of viral material on polymerase chain reaction (PCR), negative serology, CSF examination for birefringent material, and cranial imaging may be quite helpful, as discussed separately. ●Older men can develop recurrent urinary tract infections with increasing frequency, largely due to obstructive and/or neurogenic abnormalities. Because of this, signs and symptoms of staph infections vary widely, depending on the location and severity of the infection. Inflammatory bowel disease occasionally coexists with antibody deficiencies. This is also known as recurring acute otitis media. Respiratory infections are infections that happen in the lungs, chest, sinuses, nose and throat. HIV testing, hemoglobin electrophoresis, and serum and urine electrophoresis for multiple myeloma may be indicated. If so, these recurrent infections may be a sign of an immunodeficiency disorder. However, secondary immune defects due to other medical disorders are sometimes identified, while primary immune defects presenting in adults are rare. The immune system is smart and has the ability to learn the “face” of a germ and remember it. — Cellulitis is likely to recur in the setting of lymphatic stasis (lymphedema) and/or breaches in the skin barrier (eg, dermatophyte infections or trauma). Some oral infections are more serious than others. Click here to listen to the podcast. However, recurrent urinary tract infections are also a common problem in sexually active women without any identifiable predisposing condition. — Recurrent abscess formation in the same anatomic location often arises from a local defect, such as a congenital branchial cleft cyst, pilonidal or urachal cyst, hidradenitis suppurativa, or a retained foreign body. In adults with a chronic cough, i.e. This type of conjunctivitis is often associated with blepharitis. Herpes simplex occurring outside of the mouth, lips, and genitals can also be mistaken for herpes zoster, so it is important to confirm the type of infection. ●For patients with recurrent infections that may be due to an underlying anatomic abnormality or may not actually be infectious in nature, such as sinusitis or urinary tract infection, referral to a specialist in that organ system may be most helpful (eg, otolaryngologist, urologist/urogynecologist). And `` watchful waiting., depending on the location and severity the! 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