[CIS PIDD] [cis-pidd] Re: [cis-pidd] recurrent pneumonia

[CIS-PIDD]

Richard,

Any bronchiectasis or structural lung abnormality, consider HRCT or bronch?  Consider sweat testing (possible borderline result)? 

Best,

John

John B. Meiser, M.D., P.A. 
Allergy and Asthma Center of Texas
6946 Lebanon Rd.
Frisco, TX 75034
www.aactmd.com
office:  972-377-9987
fax:  972-377-9906


>  -------Original Message-------
>  From: CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
>  To: CIS-PIDD <cis-pidd at lyris.dundee.net>
>  Subject: [cis-pidd] recurrent pneumonia
>  Sent: 01 Jun '16 06:06
>  
>  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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