### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My name is Rajesh Kumar and am writing to you in context to my 8 year old son, Kumar Rishit. He does not keep well with his health quite often, has weaker immunity and is also allergic. I got your reference from the SGRH Website and hope you are the right Doctor that I am writing to. Hope you would respond to it, and then we can fix-up an appointment accordingly. Rishit has a history of poor health, as I would like to list his hospitalizations as follows - May 2007: Was hospitalized with Septicemia for 8 -10 days; treatment left him with partly impaired hearing loss due to Amikacin toxicity. Hearing is however better now. March 2008 & July 2008: Hospitalized with high fever June 2010: Hospitalized with severe coughing and vomiting 11 Jan 2011: Hospitalized with stomach pain and fever (3 days) 25 March 2011: Hospitalized for lower chest pain, fever (3 days) -- minimal pleural effussion in lungs found (both lungs), WBC = 21000 03 April 2011: re-hospitalized again as the pain did not recover (3 days) - minimal pleural effussions were persisting, WBC= 14000, treted with antibiotics and recovered. 11 May 2011: hospitalized for vomiting, fever, pain in stomach (3 days) - minimal pleural effussion recurrance in left lung, WBC= 38000. Discharged with antibiotics and is recovering. Tests carried out: (over the periods) CBC: Usually the WBC Counts are raised above 25000, Neutrophils above 80 MP/Widal/CRP-- Negative, no findings TB Feron Test-- Negative; carried out on 4th April 2011. CT Scan: show normal organs, except for minimal pleural effussion in the lower lungs; carried out on 4th April 2011 HIV I &II -- Negative; carried out on 12 May 2011 (were negative earlier also) Bone Marrow Biopsy -- Normal, no abnormality found; carried out on 12 May 2011 X-Rays have indicated the minimal pleural effussions since March 25, 2011 (fluid not enough to take out for testing) Chest/Abdomen Ultrasound -- normal report/all organs reported ok, except for minimal pleural effussion, after 25th March Rishit has been getting fever (infection ??) quite often since last 4 years, though he was quite alright during August 2008- June 2010. He was able to attend school only for about 25% of his school days, due to health issues during July 10-April 11. Now since he is getting into hospital every month, I am really very much concerned. Please advise. Thanks a lot. Rajesh Kumar

### output:

Your son has recurrent bacterial infections which requires hospitalization and few of them can cause the pleural effusions like staph. And strep. So there seems to be an immunodeficiency not with the cellular type because the wight count is high, but with the antibodies, which is caused by hypogammaglobenemia.another uncommon disorder which can give chest and abdominal pain, fever and effusions is familial middetrainan fever, its uncommon outside the Middle East, but it can occur, so I recommend the following tests : immunoglobulin: Egg and subclasses, IGM, IGE.CD marker 18 and 16 FMF gene mutation by PCR I hope this helps