[CIS-PAGID] XLA / helicobacter

[Turvey, Stuart]

Dear Charlotte and colleagues,

I think this is a great use of the collective power of the CIS-PAGID listserv.

About 12 months ago I posted a similar question about a 15yo boy with XLA and lower leg skin infection (plus bacteremia) with Helicobacter bilis/Flexispira rappini. Based on feedback from Mary Ellen Conley and others, we treated this boy with a full 12 month course of ertapenem, azithromycin and levofloxacin. He has done remarkably well, although I do acknowledge that our antimicrobial strategy was quite aggressive.

It would be a great addition to the literature if the CIS-PAGID group could collectively answer your questions and provide guidance on how to recognize, diagnose and treat this rare but debilitating infection.

I look forward to hearing from others who have dealt this this problem.

Stuart

Stuart Turvey MB BS DPhil
Associate Professor
Division of Infectious and Immunological Diseases
University of British Columbia
BC Children's Hospital and Child & Family Research Institute
950 West 28 Avenue
Vancouver BC V5Z 4H4
Ph: 604 875 2345 x5094
Fax: 604 875 2226
________________________________
From: pagid-bounces at list.clinimmsoc.org [pagid-bounces at list.clinimmsoc.org] On Behalf Of Charlotte Cunningham-Rundles at mssm.edu [charlotte.cunningham-rundles at mssm.edu]
Sent: July 23, 2011 7:38 AM
To: PAGID
Subject: [CIS-PAGID] XLA / helicobacter

Hi,

We have a case of a 25 year old man with leg swelling, pyoderma gangrenosum,  gram neg bacteremia but no fever or increased WBC,   that I think it will prove to be a Helicobacter. He is not yet proven to have XLA but has no B cells and I assume with profound hypogammaglobulinemia and early onset, this is likely what he has.

  I know there are cases reported around the US and world, but wonder, if we as a group:


 1.  Can make a rough count of the cases?
 2.  Say what antibiotics worked in the long run?
 3.  Are there any cases in CVID or other congenital immune defects?

Charlotte

Charlotte Cunningham-Rundles MD PhD
Department of Medicine
Immunology Institute
Mount Sinai School of Medicine
1425 Madison Avenue
New York City, New York 10029

212 987 5593 fax
212 659 9268 telephone

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