Why are recurrent bacterial infections seen in pediatric HIV infection?

Updated: Mar 05, 2020
  • Author: Delia M Rivera, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Recurrent bacterial infections are seen in children who are HIV positive because of the abnormal B-cell response and consequent defective humoral immunity. A variety of bacterial infections occurs, the most common of which is caused by Staphylococcus aureus. As the CD4+ count decreases, invasive bacterial infections, including sepsis and pneumonia, may occur.

Sepsis, otitis media, impetigo, cellulitis, and furunculosis have been reported. Although the infections may initially manifest in a manner similar to that in a child who is not immunocompromised, widespread and persistent infection should prompt consideration of HIV status. Acral lesions should be sought if sepsis is a concern because a pustule on the sole may be the first sign of sepsis.

Atypical presentations, such as plaquelike staphylococcal folliculitis, are also reported.


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