[CIS PIDD] [cis-pidd] recurrent pneumonia

[CIS-PIDD]

Cyclic neutropenia?
Not straight forward, but maybe she needs an unfortunate combination of both, low neutrophils plus huge germ exposure to become sick?
ELA2 can manifest in adulthood.
Lymphocytes subsets are normal, I assume.
Bodo

****************************************
Univ.-Prof. Dr. med. B. Grimbacher

Scientific-Director
CCI-Center for Chronic Immunodeficiency
UNIVERSITÄTSKLINIKUM FREIBURG
Tel.: 0761 270-77731  Fax: -77744
Breisacherstraße 115, 79106 Freiburg
bodo.grimbacher at uniklinik-freiburg.de
www.uniklinik-freiburg.de/cci

and

Consultant Immunologist
Institute of Immunity & Transplantation
Dept of Immunology
Royal Free Hospital
UNIVERSITY COLLEGE LONDON
Pond Street
London NW3 2QG
b.grimbacher at ucl.ac.uk
www.centreforimmunodeficiency.com

Von: CIS-PIDD <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>>
Antworten an: CIS-PIDD <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Datum: Wednesday 1 June 2016 14:06
An: CIS-PIDD <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Betreff: [cis-pidd] recurrent pneumonia


Colleagues:

I would like suggestions on a 46 yo female anesthesiologist with recurrent pneumonia. She has had five episodes of pneumonia over the last 15 years. Two requiring hospitalization and one ICU admission. Her most recent pneumonia admission occurred despite beginning levofloxacin within three hours of the onset of symptoms. Her infection history includes recurrent sinusitis when young that has become a much less frequent problem, a large cellulitis after a stingray envenomation and MRSA sinusitis following surgery. She is a non-smoker. Her most recent pneumonia occurred while on vacation and was not hospital acquired.

IgG 1070   IgA 132   IgM 125

Responded to 17/23 pneumococcal serotypes, adequate response to DT and H. flu. CH50 and AH50 normal.

Mannose binding lectin undetectable.

Suggestions for additional studies?

Given the fact that she averages less than on infection per year, I have been unenthusiastic about antibiotic prophylaxis. Any management recommendations?

Thank you,

Richard Wasserman

Dallas

--
Richard L. Wasserman, MD, PhD
Allergy Partners of North Texas
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211

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