[CIS PIDD] [cis-pidd] chronic rhinosinusitis in ADA SCID patient

[CIS-PIDD]

Dear colleagues,

I am seeking input on a teenage ADA SCID patient (s/p non-conditioned haplo BMT with persistent T cell lymphopenia) with chronic rhinosinusitis.  He has been on multiple rounds of culture-directed oral antibiotics with fair response.  His sinus CT demonstrates mild mucosal thickening.  Scoping by ENT demonstrates persistent purulence with cultures growing H. influenzae type A beta-lactamase negative and sensitive to all testing antibiotics except TMP/SMX.  He has been treated repeatedly with augmentin and is a highly adherent patient.  His monthly IVIG dose has been increased with most recent IgG trough 944 mg/dl.  Intranasal steroids have been tried (OMCs are patent). He does nasal lavage with sterile normal saline 2x/daily.

He has fair response to oral antibiotics and has a history of severe C. Diff colitis.  His quality of life is not bad, but he has frequent sore throat. occasional cough, and intermittent serous OM.

Are any of you aware of new approaches to this common problem in our patient population or can share anecdotal successes?

Thank you


Christine M. Seroogy MD,  FAAAAI
Associate Professor
University of Wisconsin School of Medicine and Public Health
Department of Pediatrics
Division of Allergy, Immunology & Rheumatology
1111 Highland Avenue
4139 WIMR
Madison, WI  53705-2275
phone: 608-263-2652
fax: 608-265-0164






---
You are currently subscribed to cis-pidd as: pagid at list.clinimmsoc.org.
To unsubscribe click here: http://cts.dundee.net/u?id=96396833.5a9591ccd1e327fe6bc4d1543298c482&n=T&l=cis-pidd&o=3659989
or send a blank email to leave-3659989-96396833.5a9591ccd1e327fe6bc4d1543298c482 at lyris.dundee.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://pairlist7.pair.net/pipermail/pagid/attachments/20160525/cfeb171d/attachment-0001.html>