Infections of the nose and paranasal sinuses in adult patients with immunodeficiency.

Twenty-two patients with common variable immunodeficiency (CVID) and 18 patients with selective IgA deficiency were examined with respect to previous and present infections of the upper respiratory tract (URT), especially of the nose and paranasal sinuses. Recurrent acute rhinosinusitis was common in both groups of patients, but the development of chronic rhinosinusitis was only found in patients with CVID, indicating the more severe nature of this condition compared with selective IgA deficiency. The infections of the URT occurred several years before the appearance of lower respiratory tract (LRT) infections. Once the infections of the LRT had started, the patients had a tendency to neglect the symptoms from the URT. Early detection of antibody deficiency syndromes is of vital importance for prevention of repeated and chronic infections often causing tissue damage in the respiratory tract.