Adults who get sinus infections, ear infections, bronchitis, or pneumonia repeatedly may have an underlying immune problem that has not been identified. A complete immune workup can identify the cause and guide treatment that prevents future infections — rather than just treating each one as it happens.
The pattern of repeated infections matters. Four or more sinus infections in a year, two or more pneumonias in any timeframe, or chronic bronchitis requiring multiple antibiotic courses are not normal and should prompt evaluation. So should bronchiectasis identified on imaging in someone with no obvious risk factor.
Many patients with recurrent infections have spent years cycling through urgent care, primary care, and specialist visits without anyone connecting the pattern. The underlying cause may be a primary immunodeficiency such as CVID or Specific Antibody Deficiency, an IgG subclass deficiency, a complement deficiency, or a structural problem in the airways or sinuses. A complete immune evaluation is the path to identifying which.
Standard evaluation at Optimed Immunology includes quantitative immunoglobulins (IgG, IgA, IgM, IgE), IgG subclasses, specific antibody response testing to vaccine antigens (with pre- and post-vaccination titers when indicated), lymphocyte subset analysis, and complement studies (CH50, C3, C4). HIV screening is performed when appropriate. Secondary causes are considered and addressed.
Coordination with pulmonology and ENT is common — to evaluate structural contributors and to review prior imaging. The goal is a definitive answer about why infections keep recurring, not another round of antibiotics for the latest one.
Treatment is directed by findings. For patients with primary antibody deficiency, immunoglobulin replacement therapy substantially reduces infection frequency for many patients. For others, prophylactic antibiotics during high-risk seasons may be appropriate. Vaccination optimization and management of contributing structural disease (such as chronic sinusitis or bronchiectasis) are part of comprehensive care.
Many patients describe substantial improvement in infection frequency, energy levels, and quality of life within months of starting the right treatment.
The first visit lasts 45 to 60 minutes and focuses on building a complete picture of your infection history. Bring or send any prior records — past lab work, imaging, hospital discharge summaries, prior immunology workups. Dr. McNeil reviews these in detail and discusses which additional tests are needed and why. A clear plan is provided in writing.
Donald L. McNeil, MD · Board Certified in Allergy & Immunology and Internal Medicine
This page is provided for educational purposes and does not substitute for clinical judgment or direct medical advice. Treatment decisions are individualized based on your full history, examination, and laboratory findings. If you have an emergency, call 911.