Pleuropulmonary colibacillus infection in a 9-year-old boy leading to the diagnosis of Bruton agammaglobulinemia
Séaume, H.; Bouillie, C.; Baculard, A.; Blanchard, B.; Joly, C.
Annales de Pediatrie 36(1): 39-41
1989
ISSN/ISBN: 0066-2097 PMID: 2648938 Document Number: 328941
A nine-year-old boy was hospitalized for pneumonia of the left lower lobe. A left pleural effusion developed 48 hours later. The same E. coli strain was recovered from five blood cultures, pleural fluid, and middle ear fluid. Recovery was achieved after two months. Pleural lavage was performed twice daily for the first 15 days and parenteral antimicrobial therapy was given for 45 days. Because E. coli is not usually responsible for ENT or lower respiratory tract infections, an immune deficiency was sought for. The index patient had a twin in whom a history of osteomyelitis at the age of 2 and pneumonia at the age of 8 was found. Recurrent otitis had been a problem in both twins from the age of 14 months. In both twins, immunoglobulin assays led to the diagnosis of Bruton agammaglobulinemia. These two children are now receiving intravenous infusions of human immunoglobulins every three weeks. Bruton agammaglobulinemia is infrequently diagnosed at so late an age.