Respiratory infection and primary immune deficiency - what does the general physician need to know?

This review, based on a talk given at the RCPE Respiratory Medicine Symposium 2014, outlines the clinical spectrum of immune deficiency - antibody (B cell) deficiency, T cell defects and innate/phagocytic disorders - and discusses the relevant clinical presentations, investigations and treatments, focusing particularly on the management of adults with recurrent respiratory infections. It describes when to suspect a primary immunodeficiency, the first-line investigations to perform and the triggers that should prompt referral for further specialist opinion. The paper concludes with a look at a novel primary immunodeficiency, Activated PI3 Kinase Delta Syndrome (APDS).