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An unusual cause of recurrent pneumonia in adults.

Dhir V, Sagar V, Aggarwal A, Rawat A, Singhal M - Lung India (2014)

Bottom Line: It presents with recurrent infections and has been described as first presenting in adulthood with recurrent respiratory tract infections.Unlike its better known counterpart of IgA deficiency, this particular immunodeficiency is often overlooked.We present a case of selective IgM deficiency who presented with recurrent respiratory infections.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT
Selective IgM deficiency is a rare primary immunodeficiency defined as isolated low levels of IgM. It presents with recurrent infections and has been described as first presenting in adulthood with recurrent respiratory tract infections. Unlike its better known counterpart of IgA deficiency, this particular immunodeficiency is often overlooked. We present a case of selective IgM deficiency who presented with recurrent respiratory infections.

No MeSH data available.


Related in: MedlinePlus

(a) Contrast enhanced computed tomography chest axial images in lung window setting show peripheral patch of consolidation in left lower lobe (b) 1 month later on readmission for recurrent pneumonia, patchy areas of consolidations were seen in lower lobes of both the lungs
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Figure 2: (a) Contrast enhanced computed tomography chest axial images in lung window setting show peripheral patch of consolidation in left lower lobe (b) 1 month later on readmission for recurrent pneumonia, patchy areas of consolidations were seen in lower lobes of both the lungs

Mentions: This patient had a significant history of recurrent sino-pulmonary infection for the past 10 years, requiring multiple hospital admissions. In 2003, he had presented with 1 month of cough with expectoration, fever, loss of appetite and weight. Although, purified protein derivative and sputum stain for acid-fast bacilli was negative, he was started on empirical anti-tubercular therapy on the basis of radiologic findings and treatment continued for 8 months and patient improved symptomatically. In 2004, the patient had frontal and maxillary sinusitis, requiring endoscopic sinus surgery. In 2005, the patient was again admitted with pneumonia, left pleural effusion and posterior cervical lymphadenopathy. Lymph node aspiration revealed reactive hyperplasia. Patient received intra-venous antibiotics for prolonged period of 4 weeks and improved. In 2006, the patient presented with right middle lobe pneumonia along with right chronic suppurative otitis media. Sputum culture grew Pseudomonas aeruginosa; he was treated with IV ceftazidime for 4 weeks and improved. Subsequently this patient had episodes of recurrent pneumonia every year, requiring admission and IV antibiotics. In some years, he required multiple admissions for recurrent pneumonia. [Figure 2] Furthermore, he had recurrent sinusitis, requiring repeat endoscopic sinus surgery. During most of the episodes, the patient had neutrophilic leucocytosis with the white blood count ranging from 12,000 to 30,000.


An unusual cause of recurrent pneumonia in adults.

Dhir V, Sagar V, Aggarwal A, Rawat A, Singhal M - Lung India (2014)

(a) Contrast enhanced computed tomography chest axial images in lung window setting show peripheral patch of consolidation in left lower lobe (b) 1 month later on readmission for recurrent pneumonia, patchy areas of consolidations were seen in lower lobes of both the lungs
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129610&req=5

Figure 2: (a) Contrast enhanced computed tomography chest axial images in lung window setting show peripheral patch of consolidation in left lower lobe (b) 1 month later on readmission for recurrent pneumonia, patchy areas of consolidations were seen in lower lobes of both the lungs
Mentions: This patient had a significant history of recurrent sino-pulmonary infection for the past 10 years, requiring multiple hospital admissions. In 2003, he had presented with 1 month of cough with expectoration, fever, loss of appetite and weight. Although, purified protein derivative and sputum stain for acid-fast bacilli was negative, he was started on empirical anti-tubercular therapy on the basis of radiologic findings and treatment continued for 8 months and patient improved symptomatically. In 2004, the patient had frontal and maxillary sinusitis, requiring endoscopic sinus surgery. In 2005, the patient was again admitted with pneumonia, left pleural effusion and posterior cervical lymphadenopathy. Lymph node aspiration revealed reactive hyperplasia. Patient received intra-venous antibiotics for prolonged period of 4 weeks and improved. In 2006, the patient presented with right middle lobe pneumonia along with right chronic suppurative otitis media. Sputum culture grew Pseudomonas aeruginosa; he was treated with IV ceftazidime for 4 weeks and improved. Subsequently this patient had episodes of recurrent pneumonia every year, requiring admission and IV antibiotics. In some years, he required multiple admissions for recurrent pneumonia. [Figure 2] Furthermore, he had recurrent sinusitis, requiring repeat endoscopic sinus surgery. During most of the episodes, the patient had neutrophilic leucocytosis with the white blood count ranging from 12,000 to 30,000.

Bottom Line: It presents with recurrent infections and has been described as first presenting in adulthood with recurrent respiratory tract infections.Unlike its better known counterpart of IgA deficiency, this particular immunodeficiency is often overlooked.We present a case of selective IgM deficiency who presented with recurrent respiratory infections.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT
Selective IgM deficiency is a rare primary immunodeficiency defined as isolated low levels of IgM. It presents with recurrent infections and has been described as first presenting in adulthood with recurrent respiratory tract infections. Unlike its better known counterpart of IgA deficiency, this particular immunodeficiency is often overlooked. We present a case of selective IgM deficiency who presented with recurrent respiratory infections.

No MeSH data available.


Related in: MedlinePlus