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What is it about ?
In children, recurrent infections usually affect the upper respiratory tract, as in the case of a cold, otitis media or a angina. This type of recurrent upper respiratory tract infections is common in young children. A normal, healthy child has, on average, 6 to 10 respiratory infections per year. This does not require further examination.
A number of personal factors can increase susceptibility to infections:
- hereditary predisposition;
- middle ear abnormality;
- reflux (rise of the contents of the stomach towards the esophagus and the mouth).
Certain environmental factors can also intervene:
- frequent contact with infections (eg at the nursery);
- smoke around the child.
A predisposition to allergies does not make the child more susceptible to infections.
If the child has more infections than is considered normal, it may be because of a problem with the normal defense mechanism against infections. This is called an immune disorder.
What is its frequency?
Boys are more likely to get infections than girls.
Young children who go to nursery have 1.5 to 3 times more infections than children who stay at home.
How to recognize them?
The vast majority of children have normal immune systems. The following characteristics suggest that the resistance, immunity of the child is normal:
- The appearance of recurrent infections coincides with the first visits to the nursery.
- Infections only affect the respiratory tract.
- Infections are caused by viruses.
- Recovery after each infection is proceeding normally.
- The child growth is normal, as is its development.
- Clinical examination is normal (apart from infection).
- There is no family history of a high predisposition to infections.
The following symptoms may suggest a disease of the immune system:
- purulent (pus-producing) or generalized infections caused by bacteria (abscess, more than 2 pneumonias per year, more than 2 sinusitis per year, sepsis…);
- more than six episodes ofotitis media purulent per year, chronic perforation of the eardrum or rock infection;
- chronic infection of the mucous membranes of the mouth, nails or skin, warts very important or skin abscess or recurrent soft tissue;
- insufficient recovery after treatment with antibiotics, and this on several occasions;
- stunted growth of the child and diarrhea long-lasting or benign inflammation of the skin;
- family history of problematic infections, death from infections or serious immune disorders.
How is the diagnosis made?
The doctor will start by asking a few questions:
- the age of the child at the onset of the first infection;
- the number of infections and their duration;
- the type of infections;
- recovery from infections;
- symptoms in the stomach and skin;
- the breathing problems ;
- the presence of a reflux ;
- family history;
- where does the child spend the day (at the nursery, with a foster mother, at home, etc.);
- parental smoking.
Then the doctor performs a physical exam. The doctor first checks the child growth and development using growth charts. Then he does a full clinical examination, during which he examines the nose, throat and ears, he auscultates the heart and the lungs, he feels the belly and he inspects the skin and mucous membranes.
The doctor will also take a blood test to look for the underlying cause.
An x-ray of the lungs or sinuses is usually not necessary, unless the doctor suspects recurrent pneumonia during an acute infection.
What can you do ?
First of all, stop smoking at home. If necessary, put the child in a nursery with a smaller group of children or keep them at home more often.
In older children who have frequent middle ear infections, chewing gum with sweeteners may be beneficial after a meal.
It is advisable to vaccinate against flu and against pneumococci.
What can the doctor do?
A specialist will need to decide on the individual treatment and approach, depending on the age of the child at the onset of symptoms, the nature of the symptoms, the general state of health, the nature of the infections and the agents. pathogens (viruses or bacteria).
An ENT (otolaryngologist, doctor specializing in the nose-throat-ears area) will determine whether the tonsils should be removed and / or whether drains (diabolos) should be placed through the eardrum.
A pediatrician will decide on the necessary additional examinations if an immune disease is suspected.
Source
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