🛡️ Immunology · Clinical Immunology
B cell defects: bacterial infections. T cell defects: viral + fungal + intracellular. Combined: everything.
Immunodeficiency Patterns — Match the infection type to the immune defect
B
B cell / antibody deficiencies
Conditions like XLA (X-linked agammaglobulinemia) and CVID (common variable immunodeficiency) impair antibody production, leading to recurrent pyogenic bacterial infections — especially encapsulated organisms like S. pneumoniae and H. influenzae — along with Giardia and enteroviral encephalitis.
T
T cell deficiencies
Conditions like DiGeorge syndrome (thymic aplasia) and HIV impair T cell function, leading to susceptibility to viral infections (CMV, HSV, EBV), fungal infections (PCP, Candida, Cryptococcus), and intracellular pathogens (Toxoplasma, Mycobacteria) — the categories of pathogen that specifically require T cell-mediated defense.
SCID
Combined deficiencies
SCID (Severe Combined Immunodeficiency) knocks out both B and T cell function, leaving the patient vulnerable to essentially every category of infection — bacterial, viral, fungal, and intracellular all at once.
C
Complement deficiency — a special case
Deficiency in the terminal complement components (C5-C9), which form the membrane attack complex, causes a very specific vulnerability to Neisseria infections in particular — a useful, narrowly-testable exception to the broader B cell/T cell pattern.
1
A child has recurrent bacterial sinopulmonary infections (S. pneumoniae, H. influenzae) but handles viral infections normally. This pattern points toward a B cell/antibody deficiency, like XLA or CVID.
2
A different infant develops recurrent CMV, fungal, and Mycobacterial infections, but handles ordinary bacterial infections without unusual difficulty. This pattern instead points toward a T cell deficiency, like DiGeorge syndrome.
3
A third infant develops severe infections across every category — bacterial, viral, fungal — starting from a very young age. This broader vulnerability pattern points toward a combined deficiency like SCID.
4
A fourth patient has a specific, recurrent susceptibility to Neisseria infections and nothing else unusual — this narrow, specific pattern points toward a late complement component (C5-C9) deficiency rather than a general B or T cell problem.

Exams test whether you can match a described infection pattern (bacterial-only, viral/fungal/intracellular, or combined) to the correct type of immunodeficiency, and whether you know the specific Neisseria association with late complement component deficiency.

The most common trap is treating all immunodeficiencies as if they cause the same broad vulnerability. The infection pattern is diagnostic: bacterial-only points to B cells, viral/fungal/intracellular points to T cells, everything-at-once points to combined deficiency, and Neisseria-specific points to late complement deficiency.

1. What infection pattern is characteristic of B cell/antibody deficiency?
Recurrent pyogenic bacterial infections, especially encapsulated organisms like S. pneumoniae and H. influenzae.
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2. What infection pattern is characteristic of T cell deficiency?
Viral (CMV, HSV, EBV), fungal (PCP, Candida, Cryptococcus), and intracellular (Toxoplasma, Mycobacteria) infections.
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3. What does SCID affect, and what's the resulting infection pattern?
Both B and T cell function; patients become vulnerable to essentially every category of infection.
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4. What specific pathogen is associated with late complement component (C5-C9) deficiency?
Neisseria.
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5. Name two conditions that cause B cell/antibody deficiency.
XLA (X-linked agammaglobulinemia) and CVID (common variable immunodeficiency).
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