Sttudy off Neuttrophiill Functtiion (Phagocyttiic Functtiion) iin Pattiientts wiitth Recurrentt Skiin Abscesses

Abstract

Recurrent skin abscesses is a leading cause for transferal to immunologists, while most of these patients have normal immunity and with no underlying primary immune deficiency disease. Neutrophils is the most abundant cell in WBCs and the first cell to encounter bacteria and infections, it has a lot of rule not only being dump phagocytic cell that die after performing its task. Primary defects in neutrophil function are not common in the general population, but require very aggressive and specific management and lifelong prophylaxis in some cases. Primary phagocytic cell defects account for 10 to 15% of primary immunodeficiency’s, the ability of phagocytic cells to kill pathogens is impaired. Cutaneous infections are characteristic. Primary phagocytic defects must be included in the differential diagnosis of recurrent infection and fever in a child and occasionally in an adult. Early diagnosis is essential, because manifesta-tions of infection are usually blunted and rapid intervention can be lifesaving. One of the Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America recommends for recurrent skin abscesses is that Adult patients should be evaluated for neutrophil disorders especially if abscesses began in early childhood. In our study we found significant relation between neutrophil phagocytic cell dysfunction and recurrent skin abscesses in age group from 18 to 42. The clinical manifestations most indicative of phagocytic dysfunction are deep-seated abscesses, suppurative lymphadenitis, sepsis, pneumonia, bone and joint, CNS, and oral mucosal infections. The more extended the organ involvement, the greater the chance for finding a phagocytic impairment. Establishing early diagnosis and offering appropriate treatment and genetic counseling for these patients and their families are essential to prevent premature mortality and the damage inflicted by chronic infection. The high rate of idiopathic phagocytic impairment is probably related to the deleterious effects of persistent infection, drug consumption, or disorders not yet established. So these must be excluded in history and test must be repeated.