During an evaluation, which symptom would indicate a possible primary immunodeficiency in a child with recurrent infections?

The presence of ten ear infections in the past year is a significant indicator of a possible primary immunodeficiency in a child. Primary immunodeficiencies are characterized by the body's inability to properly respond to infections, and recurrent infections, particularly of the same type or in the same area, are a hallmark sign.

In children, experiencing frequent infections—like multiple ear infections—can suggest that the immune system is not functioning as it should, leading to an increased susceptibility to infections that a healthy immune system would typically manage without issue. This symptom stands out as a cause for concern and prompts further investigation into the child’s immune function.

While other symptoms could indicate health issues, they do not inherently suggest primary immunodeficiency in the same way recurrent infections do. For instance, a superficial wound or a history of fungal diaper rash may arise from other factors, and a child's weight within age-appropriate parameters does not provide insight into their immune status. Thus, the history of ten ear infections is the clearest indicator of a potential underlying immunodeficiency needing further evaluation.