Table 2.

Pointers that should lead to further investigation in a child with recurrent pneumonia.

Pointers in the History	- Unexplained death, severe infections or multisystem disease in the family
	- Unusual organisms or any feature of a systemic immunodeficiency
	- Respiratory infection plus extrapulmonary infections or other disease
	- Chronic rhinosinusitis and/or otitis media from the first months of age
	- Very sudden onset of symptoms
	- Chronic moist cough/sputum production
	- More severe symptoms or irritability after feeds and when lying down
	- Continuous, unremitting, or worsening symptoms
Pointers in the Physical Examination	- Severe infection
	- Persistent infection and failure of expected recovery
	- Prolonged interstitial pneumonia with no detectable infective cause
	- Digital clubbing, signs of weight loss, failure to thrive
	- Unusually severe chest deformity
	- Fixed monophonic wheeze or asymmetric wheeze
	- Signs of cardiac or systemic disease
	- Persistence of lung crackles on auscultation for more than eight weeks