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Primary Immunodeficiency

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40 Chronic mucocutaneous candidiasis (CMCC) Î SS 187. Patients who present exclusively with recurrent Candida species infection of nails, skin, and mucous membranes should be considered for the diagnosis of CMCC. (C) Î SS 188. Evaluation of patients with suspected CMCC should include NK cell numbers and functional studies and assessment of T-cell response to Candida species. (C) Î SS 189. Antifungal agents should be the mainstays of therapy for CMCC. (C) Susceptibility to trypanosomiasis Î SS 190. Patients with sleeping sickness caused by Trypanosoma evansi should be studied for mutation in the apolipoprotein L1 (APOL1) gene. (C) Selective NK cell defects Î SS 191. Patients with severe disease caused by herpesviruses or papillomaviruses who do not have another defined immunodeficiency should have phenotypic and functional assessments of NK cells. (C) Î SS 192. Patients with a selective functional NK cell defect should be screened for mutations affecting CD16 by using flow cytometry with the anti-CD16 clone B73.1. (C) Î SS 193. Patients with growth retardation, adrenal insufficiency, and NKcell deficiency should be tested for the MCM4 mutation. (C) Î SS 194. Patients with selective NK cell defects might benefit from specific chemoprophylaxis against herpesviruses and vaccination against HPV. (C) Isolated congenital asplenia (ICA) Î SS 195. Patients presenting with a family history of asplenia or sepsis caused by encapsulated bacteria, most frequently S. pneumoniae, should be evaluated for congenital asplenia. Î SS 196. Patients with ICA should be started immediately on antibiotic prophylaxis and receive vaccination for encapsulated organisms. Defects of Innate Immunity

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