Streptococcal pneumonia meningitis as an initial presentation of X‐linked agammaglobulinemia: A case report and discussion

Journal of the American College of Emergency Physicians Open

卷:2

Kalyani Marathe¹  Daniel Kadden¹  Craig Gosdin¹  Casey Logan¹  Elissa Engel¹  Grace Fowler¹ 

[1] UC College of Medicine, Department of Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA;

关键词: absolute neutrophil count;    bacterial meningitis;    Bruton's tyrosine kinase;    ecthyma gangrenosum;    Staphylococcus aureus;    X‐linked agammaglobulinemia;   

DOI  :  10.1002/emp2.12553

来源: DOAJ

【 摘 要 】

Abstract X‐linked agammaglobulinemia (XLA) is a primary immunodeficiency caused by mutations in the gene for Bruton's tyrosine kinase (Btk), with affected males most commonly presenting with recurrent bacterial infections during the first few years of life. Here we present a 17‐month‐old male with a chief complaint of worsening rash and fever, whose history of streptococcal pneumonia meningitis at 5 months of age prompted suspicion for an underlying immunodeficiency and subsequent diagnosis of XLA. Bacterial meningitis is a rare initial presentation of XLA, and therefore physicians may easily overlook any underlying immunodeficiency. Prompt workup for immunodeficiency should be initiated in any vaccinated patient with a history of pneumococcal meningitis outside of the newborn period. Further discussion surrounding the various presentations of XLA, their related clinical manifestations and laboratory findings, and the importance of thorough chart review may encourage earlier diagnosis and initiation of treatment of this disease.

【 授权许可】

Unknown