REPEATED INVASIVE PNEUMOCOCCAL INFECTIONS IN YOUNG-CHILDREN WITHOUT APPARENT UNDERLYING IMMUNODEFICIENCY

During a 30-month interval at LeBonheur Children's Medical Center, 394 patients had a blood or cerebrospinal fluid culture positive for Stre ptococcus pneumoniae. Sixteen of these episodes (4%) were repeated inf ections; 6 of these 16 patients had sickle cell disease. Six of the re maining 10 patients had immunologic evaluations of varying completenes s; no immunodeficiency was identified by these tests or on follow-up. Nine of the ten previously healthy patients with repeated pneumococcal disease were less than 2 years of age. In our experience, repeated in vasive pneumococcal infections in otherwise healthy young children wer e relatively common (10/394, or 2.5% of patients with invasive pneumoc occal infections) and did not indicate the presence of an unsuspected immunodeficiency.