A 26-year-old woman presented with a chief complaint of recurrent upper respiratory and sinus infections. She reported that during the last 2 years, she had experienced 4 sinus infections lasting longer than 1 week requiring antibiotic therapy and multiple sinopulmonary infections during the spring and fall. Before this, she denied any history of recurrent sinus infection, upper respiratory tract infection, acute otitis media, diarrhea, pneumonia, or other infection. Review of systems was negative for fevers, chills, unexplained weight loss, rashes, warts, other skin concerns, or any current symptoms except for anxiety. Medical history was significant for migraine headaches, bipolar 2 disorder, syncope, and premature ventricular complexes. Medications were oxcarbazepine, lamotrigine, venlafaxine, and metoprolol. There was no known family history of immunodeficiency.
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