[CIS PIDD] [cis-pidd] Latent TB and a history of recurrent pneumonia

[CIS-PIDD]

Hi, Dr. Wasserman:

Sounds fairly routine latent TB to me.  Alternatively, if he's exposed to farms / animals or eats raw cheese / milk (given his interest in working in a zoo ...), it might even be M. bovis (wild type, not the BCG strain), which should give you positives for both PPD and Quantiferon.

I would not do anything differently from your routine kid with latent TB.

  - K 

Karl O. A. Yu, M.D., Ph.D., F.A.A.P.
Section of Infectious Diseases  |  Department of Pediatrics  |  Comer Children's Hospital  |  University of Chicago
5841 S Maryland Ave,  MC 6054,  Chicago  IL  60637
Office phone: 773-702-9281  |  Pager: 773-702-6800 x1744  |  Fax: 773-702-1196



________________________________________
From: CIS-PIDD [cis-pidd at lists.clinimmsoc.org]
Sent: Wednesday, February 15, 2017 3:50 PM
To: CIS-PIDD
Subject: Re: [cis-pidd] Latent TB and a history of recurrent pneumonia

No, prior evaluations, done more than five years ago, were limited to Ig levels and vaccine responses.
Richard

On Wed, Feb 15, 2017 at 12:37 PM, CIS-PIDD <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>> wrote:
Any previous lymphocyte subsets?

Ayça Aslan Kıykım, MD
Marmara University
Pediatric Allergy and Immunology
Istanbul TURKEY


CIS-PIDD <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>> şunları yazdı (15 Şub 2017 20:59):

I followed a child from age 4-12 during which time he had more than seven x ray documented lobar pneumonias and some otitis and sinusitis but no other bacterial infections. Reported to have had prolonged courses of routine viral illnesses but always recovered. Never cultured an unusual organism. No fungal infections. Normal growth and development. Evaluated several times for an antibody production defect and always had normal Ig's and vaccine responses. Normal granulocyte function, normal complement.

Lost to follow up for four years. Returns with a positive PPD and a reactive quantiferon gold obtained because he was volunteering at the zoo. Asymptomatic, normal chest x ray. Since I last saw him, he has had only a few viral URI's, no pneumonias, no courses of antibiotics.

The question is, have I missed looking for something? Is he immunologically normal despite his now distant history of pneumonias. Can he be treated like a normal person with latent TB? The family is anxious to be sure there is no missed problem.

Pending studies, IgA, IgG, IgM, vaccine serologies, CBC, T and B cell phenotyping.

Thanks,
Richard

--
Richard L. Wasserman, MD, PhD
Allergy Partners of North Texas
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788<tel:(972)%20566-7788>
Fax (972) 566-8837<tel:(972)%20566-8837>
Cell (214) 697-7211<tel:(214)%20697-7211>

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--
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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