Question:
I had sinus surgery 8 months ago. Since then I have been on 5 courses of steriods and 8 courses of antibiotics for the 8 sinus infections I have had post surgery. As soon as I get off an antibiotic, within a few days, I get another infection. I also have been doing a nasal mist with three antibiotics (bethmethasone, tobramycin and mupirocin). I have become totally unresponsive to antibiotics. I am desperate and starting to loss hope. I am interested in IGG because I believe the problem is my immune system. Do you know of an resources in the DC area that could help me with this?
Answer:
Thanks for your question. There is a small group of people who have recurrent respiratory infections, in spite of treatment, because of a weaknesss in their immune system. This is not related to AIDS. Generally these people have a “partial immune deficiency”- that is their white blood cells do not fight certain bacteria well. This causes them to be more susceptible to infections. Infections caused by immune deficiency can be treated successfully by supplementing one’s own immune cells with immunoglobulins given intravenously.
The best way to see if that is your problem is to be tested for this. It certainly makes sense at this point to do so. This type of evaluation is usually done by an immunologist. (a subspecialty within Allergy-Immunology) I would ask your doctor, or your own allergist if you have one, who is best for this – Should that not be the case, immunoglobulins would not likely be of help. I would look to for other, untreated causes of your problems- either at the NY Sinus Center or nearer to home.
I hope this clears things up.
Robert Pincus MD
NY Sinus Center
Frequently Asked Questions
Recurrent sinus infections after surgery that do not respond well to antibiotics may be due to an underlying partial immune deficiency. This means that the immune system, particularly the white blood cells, may not be effectively fighting certain bacteria, making the patient more susceptible to frequent infections.
Immunoglobulin therapy involves supplementing a person's immune system by giving immunoglobulins intravenously. This treatment can help individuals with partial immune deficiency by providing the antibodies that their own immune system fails to produce adequately, thereby reducing the frequency and severity of infections.
To determine suitability for immunoglobulin therapy, a patient should undergo specialized testing typically performed by an immunologist, who is skilled in Allergy-Immunology. This evaluation assesses whether the immune system is deficient and if immunoglobulin therapy would likely be beneficial.
If frequent infections are suspected to be immune-related, you should consult with your primary doctor or an allergist. They can refer you to an immunologist for specialized testing and evaluation. Additionally, sinus specialists such as those at the NY Sinus Center may offer further insight or treatment options.
No, recurrent infections resulting from partial immune deficiency discussed here are not related to AIDS. They involve different mechanisms and should be evaluated separately by medical professionals.
If immunoglobulin therapy is not suitable, it is important to explore other untreated causes of sinus infections. This might include further evaluation at specialized centers such as the NY Sinus Center or other local sinus specialists who can investigate additional factors contributing to persistent infections.
