2½-year-old with multiple antibiotic hypersensitivities, recurrent infections, extreme IgE/eosinophilia, and abnormal T-cell testing. Looking for a direction and a plan.
Female 2.5 years 36 inches tall and 31lbs
I'm hoping someone with expertise in pediatric immunology, Allergy & Immunology, infectious disease, dermatology, or inborn errors of immunity might be willing to look at my 2½-year-old daughter's history and help us figure out what direction we should be going.
I'm not asking Reddit to diagnose her. She is currently under the care of multiple specialists, including Allergy & Immunology and Infectious Disease. We've also seen multiple pediatricians, two different dermatologists, and several emergency departments.
The problem is that despite all of this, the answer I keep getting is essentially "I don't know."
I understand that medicine doesn't always have immediate answers. But we're at a point where I don't just want another test when something goes wrong. I need a proactive plan for keeping her safe.
The problem started with antibiotic reactions
One of the things that started this entire medical journey was my daughter's unusual reactions to antibiotics.
She has had clinically significant hypersensitivity reactions to multiple unrelated antibiotic classes, involving both immediate and delayed hypersensitivity mechanisms. Her treating physicians/allergists have characterized some of these reactions as T-cell-mediated.
The antibiotics involved include:
- Penicillins/amoxicillin: significant hypersensitivity reaction
- Cephalosporins, including cephalexin: significant hypersensitivity reaction
- Clindamycin: significant hypersensitivity reaction
- Azithromycin: significant hypersensitivity reaction
- Doxycycline: significant hypersensitivity reaction
- Sulfonamide antibiotics, specifically Bactrim: immediate anaphylactic reaction as well as a separate delayed hypersensitivity reaction
This is not simply one antibiotic allergy or straightforward beta-lactam cross-reactivity. She has reacted to multiple unrelated antibiotic classes, and with Bactrim she has demonstrated both an immediate severe reaction and a delayed reaction.
This has become particularly concerning because she also appears susceptible to infections. We have a very young child who may need antibiotics, while her available antibiotic options have become increasingly limited.
Infection history
My daughter is 2½ years old.
The difference between the school year and summer has been very noticeable.
During the last school year, she was sick constantly. Once school was out for the summer and the children were no longer bringing home frequent illnesses, she had no significant illnesses over the summer.
School has now started again, and I'm extremely concerned that we're going to see the same pattern return.
In 2026 she has had approximately:
- 8 ear infections
- Approximately 12 skin infections/episodes treated as infection
- At least 1 confirmed Staph infection
- Multiple episodes of cellulitis, although cultures were not obtained every time
- No diagnosed sinus infections
- No diagnosed invasive fungal infections
- No abscesses
- No thrush
- Ongoing/recurrent yeast problems in the diaper area
- More than a dozen emergency-room visits
- No hospitalizations
Usually, one appropriate antibiotic course is enough to treat an infection.
She also has a history of very high fevers, including temperatures >106°F.
Extensive infectious/dermatologic investigation
Because of the unusual skin presentations, we've repeatedly investigated infectious causes.
Testing/evaluation has included investigations for:
- Chickenpox/varicella
- Mpox/monkeypox
- Measles
- Mumps
- Hand, foot, and mouth disease
- Molluscum contagiosum
These investigations, including PCR testing where appropriate, have not identified those infections.
A skin scraping/biopsy was interpreted as folliculitis.
We've seen multiple pediatricians, multiple Allergy & Immunology specialists, two different dermatologists, Infectious Disease, and several ERs while trying to determine what is actually happening.
The skin disease
The skin problems began in June 2025.
They initially appeared vesicular, followed by a secondary lacy/urticarial-type rash.
The lesions are:
- Extremely itchy
- Sometimes dramatically swollen
- Usually present for approximately 7–10 days
- Recurrent
She also has mild eczema.
She has been diagnosed with Skeeter syndrome, but her reactions to mosquito bites are unusually dramatic. One mosquito bite can become extremely swollen and inflammatory and can seem to trigger multiple additional bumps elsewhere on her skin.
We don't know whether this is part of the same underlying process or a separate allergic condition.
Her immune laboratory findings
This is where things have become particularly interesting.
IgE is extremely elevated and has been persistently so.
Her first IgE measurement was already in the 900s, which was markedly elevated. It has continued to rise and fluctuate. It has not been below 2,000 for approximately eight months and generally sits in the 3,000–4,000 range, with a highest value of approximately 4,100.
She also has persistent eosinophilia and thrombocytosis.
These abnormalities improve while she is taking systemic steroids, but return when she is off steroids.
Her most recent CBC showed:
- WBC: 11.81 K/cu mm, normal
- Hemoglobin: 11.3 g/dL, mildly low
- Platelets: 414 K/cu mm, high
- Eosinophils: 6.8%, high
- Absolute eosinophils: 0.80 K/cu mm, high
- Absolute neutrophils: 4.89 K/cu mm, normal
- Absolute lymphocytes: 5.26 K/cu mm, normal
- Atypical lymphocytes: 3%
- Platelet estimate: increased
Her IgG and IgM are normal.
Her IgA is low at 16.
Vaccine challenge/titers
She has also had a vaccine challenge followed by repeat antibody titers.
The most recent testing showed normal vaccine-specific antibody responses in all areas tested.
So despite the recurrent infections, there is not currently evidence of an obvious inability to produce vaccine-specific antibodies.
This is one of the reasons I'm having trouble figuring out where the problem lies. Her conventional antibody testing is largely reassuring, while other parts of the picture are not.
Lymphocyte proliferation testing
This is one of the results I especially want help interpreting.
The testing showed:
Candida antigen stimulation:
- CD45 proliferation: 0.7% (reference ≥5.7%)
- CD3 proliferation: 1.0% (reference ≥3.0%)
Tetanus toxoid stimulation:
- CD45 proliferation: 3.8% (reference ≥5.2%)
- CD3 proliferation: 4.9% (reference ≥3.3%)
So the Candida response was substantially below the laboratory reference range for both CD45 and CD3.
The tetanus results were different: the CD45 value was below the reference range, but the CD3 response was within the laboratory reference range.
I'm particularly interested in whether the difference between the Candida and tetanus responses is clinically meaningful, and whether this pattern suggests anything about cellular immunity or T-cell function.
I don't want to overinterpret this test myself.
Family history
There is a strong allergic history on her father's side.
All three of her paternal half-sisters have food allergies to:
- Peanut
- Cashew
- Pistachio
One is also allergic to:
- Walnut
- Sesame
I have an autoimmune disease myself, antiphospholipid syndrome.
There is no known diagnosed primary immunodeficiency in the family.
The overall question
Individually, there are explanations for many of these findings.
Severe atopy can cause very high IgE and eosinophilia.
Children get ear infections.
Drug allergies happen.
Skin infections happen.
IgA can be low for different reasons.
But when I put everything together, I keep wondering whether we're looking at something more than severe atopy:
Multiple significant hypersensitivity reactions to unrelated antibiotics + recurrent ear/skin infections + cellulitis/Staph + unusually high fevers + severe recurrent inflammatory skin disease + IgE persistently 2,000–4,000+ + persistent eosinophilia + persistent thrombocytosis + low IgA + abnormal Candida-specific lymphocyte proliferation.
Is there a unifying disorder or category of disorders that could explain this combination?
Specifically, would you be considering:
- Hyper-IgE syndromes
- Inborn errors of immunity with severe atopy
- Combined immune dysfunction
- T-cell/Th17-related immune dysfunction
- Immune dysregulation syndromes
- Disorders associated with multiple drug hypersensitivities
- Another primary immunodeficiency/immune disorder that can present with severe allergic disease
Or is this combination still compatible with severe atopy plus recurrent childhood infections and unrelated drug hypersensitivities?
What I actually need help with
This is probably the most important part of why I'm posting.
She is already under the care of specialists. I'm not trying to replace her doctors with Reddit.
What I'm struggling with is that we have accumulated a lot of information, but I don't feel like anyone is helping us turn it into a plan.
When something happens, we treat it.
When she develops another rash, we investigate it.
When she gets another infection, we treat it.
When another lab is abnormal, another test gets ordered.
But I don't feel like anyone is stepping back and asking:
What is the overall pattern? What are we trying to rule in or rule out? What should we be monitoring? What should we do proactively? And what is our plan when she inevitably gets sick again?
The last school year was extremely difficult because she was constantly getting sick. She was significantly better over the summer when the children were out of school and she wasn't being exposed to the same constant stream of infections.
Now school has started again.
I'm worried because if the pattern repeats, we're going to have a 2½-year-old who is getting frequent infections while having significant hypersensitivity reactions to many of the antibiotics we might need to use.
I don't want to wait until the next bad infection to figure out what we're going to do.
If you were seeing this child in an immunology clinic, what would you investigate next?
Are there particular immune tests, functional studies, genetic panels, vaccine antibody studies, or specific disorders that you would want to rule out?
Would you be approaching this primarily as severe atopy, or would the combination of findings make you pursue an underlying inborn error of immunity/immune dysregulation disorder?
And perhaps most importantly:
What would a reasonable proactive management plan look like while we're still trying to determine the diagnosis?
I'm exhausted from hearing "we don't know" while continuing to wait for the next problem to happen.
I'm grateful that she has doctors caring for her. I just need help figuring out what questions to ask them and what direction we should be moving in.
I have the actual laboratory reports and can provide additional values, reference ranges, specialist findings, or the complete proliferation report if that would help.
I'm not looking for a Reddit diagnosis. I'm looking for a direction and a plan to keep my daughter safe.