RT Book, Section
A1 Schroer, Brian
A1 Niehues, Tim
A1 Dückers, Gregor
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114880507
T1 B and T Cell Immunodeficiencies—Severe Combined Immunodeficiency (SCID) and Other Well Defined Primary Immunodeficiencies
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114880507
RD 2024/04/19
AB A  2.5-month-old-baby  boy  presented  to  his  pediatrician  because  of  a  10-day  history  of  diarrhea,  which  began  soon  after  his  first  series  of  immunizations,  which  included  the  oral  rotavirus  vaccine.  He  was  born  via  uncomplicated  vaginal  delivery  and  his  birth  weight  and  height  were  at  the  55  percent  percentile.  There  were  no  known  ill  contacts.  His  weight  and  height,  which  had  been  15  percent  at  two  months,  was  now  lower  and  he  had  a  fever  to  101F.  Thrush  was  noted  on  his  tongue  and  throat,  and  he  was  noted  to  have  a  diffuse  scaling  rash  on  the  face  and  hands  (Figures  219-1  and  219-2).  A  CBC  with  differential  showed  an  absolute  lymphocyte  count  of  1,200  cells/microliter.  A  chest  x-ray  was  performed  which  showed  diffuse  infiltrates  and  the  absence  of  a  thymic  shadow.  He  was  referred  to  an  immunologist  for  immediate  evaluation  and  treatment.  T  and  B  cell  subsets  were  obtained,  which  revealed  that  90  percent  of  his  lymphocytes  are  B  cells  and  that  he  had  very  low  numbers  of  T  of  maternal  origin  and  NK  cells.  He  was  treated  with  intravenous  immune  globulin  (IVIG),  placed  on  trimethoprim-sulfamethoxazole  for  Pneumocystis  jirovecii  prophylaxis  and  referred  to  a  specialized  immunology  center  for  a  bone  marrow  transplant.  His  bone  marrow  transplantation  was  successful.