Children with severe, recurrent, or unusual infections may have an underlying primary immunodeficiency disease (PID). Ten warning signs have been promoted by patient support groups to help identify children with PID, but the signs have never been tested in a rigorous scientific study.
Family history, intravenous antibiotics for sepsis, and failure to thrive predict at least 89% of children with T-lymphocyte, complement, and neutrophil PID. B-lymphocyte PID are more difficult to diagnose from the clinical features, and a lower threshold is required for assessing antibody levels.
Early onset neonatal sepsis causes serious morbidity and mortality in newborns. Substantial disease reduction has occurred with intrapartum antibiotic prophylaxis treatment of at-risk women to reduce vertical transmission of early onset group B streptococcal disease. Predominant neonatal pathogens are thought to change over time.
In a national cohort of ∼400 000 infants, rates of early onset sepsis were 0.98 cases per 1000 live births....