Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency care for:
Severe trouble breathing, blue or grey lips, or inability to speak normally
Signs of anaphylaxis, such as throat swelling, wheezing, faintness, or breathing difficulty
Confusion, extreme drowsiness, collapse, or other signs of severe infection
Coughing up a large amount of blood
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Contact the person’s medical team urgently for a new fever, worsening cough, shortness of breath, chest pain, a rapidly spreading skin infection, or a painful swelling that may be an abscess.
People with HIES do not always develop strong redness, pus, or fever, so a change from their usual health still matters.
Persistent viral skin sores, unexplained weight loss, swollen lymph nodes, or repeated night sweats also need prompt assessment.
Do not wait for the next routine appointment if symptoms suggest a significant infection.
3
Does any of this apply?
Book an appointment
Routine follow-up is appropriate for stable eczema, planned monitoring, medication reviews, dental concerns, and discussion of test results.
Every sign above is quoted from the sofidex article on Hyperimmunoglobulin E syndrome. If you are not sure, err upward — it is always reasonable to be checked.