Séaume H, Bouillie C, Baculard A, Blanchard B, Joly C
Ann Pediatr (Paris). 1989 Jan;36(1):39-41.
A nine-year-old boy was hospitalized for pneumonia of the left lower lobe. A left pleural effusion developed 48 hours later. The same E. coli strain was recovered from five blood cultures, pleural fluid, and middle ear fluid. Recovery was achieved after two months. Pleural lavage was performed twice daily for the first 15 days and parenteral antimicrobial therapy was given for 45 days. Because E. coli is not usually responsible for ENT or lower respiratory tract infections, an immune deficiency was sought for. The index patient had a twin in whom a history of osteomyelitis at the age of 2 and pneumonia at the age of 8 was found. Recurrent otitis had been a problem in both twins from the age of 14 months. In both twins, immunoglobulin assays led to the diagnosis of Bruton agammaglobulinemia. These two children are now receiving intravenous infusions of human immunoglobulins every three weeks. Bruton agammaglobulinemia is infrequently diagnosed at so late an age.
一名9岁男孩因左下叶肺炎住院。48小时后出现左侧胸腔积液。从5份血培养物、胸腔积液和中耳液中分离出相同的大肠杆菌菌株。两个月后康复。在最初的15天里，每天进行两次胸腔灌洗，并给予45天的胃肠外抗菌治疗。由于大肠杆菌通常不引起耳鼻喉或下呼吸道感染，因此对免疫缺陷进行了检查。该索引患者有一个双胞胎，在其双胞胎中发现有2岁时患骨髓炎和8岁时患肺炎的病史。自14个月大起，复发性中耳炎一直是这对双胞胎的问题。对这对双胞胎进行免疫球蛋白检测后诊断为布鲁顿无丙种球蛋白血症。这两个孩子现在每三周接受一次静脉注射人免疫球蛋白治疗。布鲁顿无丙种球蛋白血症在这么晚的年龄很少被诊断出来。
