Streptococcal pneumonia meningitis as an initial presentation of X‐linked agammaglobulinemia: A case report and discussion
Abstract X‐linked agammaglobulinemia (XLA) is a primary immunodeficiency caused by mutations in the gene for Bruton's tyrosine kinase (Btk), with affected males most commonly presenting with recurrent bacterial infections during the first few years of life. Here we present a 17‐month‐old male w...
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| Language: | English |
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Elsevier
2021-10-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12553 |
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| author | Daniel Kadden Grace Fowler Elissa Engel Casey Logan Kalyani Marathe Craig Gosdin |
| author_facet | Daniel Kadden Grace Fowler Elissa Engel Casey Logan Kalyani Marathe Craig Gosdin |
| author_sort | Daniel Kadden |
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| description | Abstract X‐linked agammaglobulinemia (XLA) is a primary immunodeficiency caused by mutations in the gene for Bruton's tyrosine kinase (Btk), with affected males most commonly presenting with recurrent bacterial infections during the first few years of life. Here we present a 17‐month‐old male with a chief complaint of worsening rash and fever, whose history of streptococcal pneumonia meningitis at 5 months of age prompted suspicion for an underlying immunodeficiency and subsequent diagnosis of XLA. Bacterial meningitis is a rare initial presentation of XLA, and therefore physicians may easily overlook any underlying immunodeficiency. Prompt workup for immunodeficiency should be initiated in any vaccinated patient with a history of pneumococcal meningitis outside of the newborn period. Further discussion surrounding the various presentations of XLA, their related clinical manifestations and laboratory findings, and the importance of thorough chart review may encourage earlier diagnosis and initiation of treatment of this disease. |
| format | Article |
| id | doaj-art-3e98c22677a64db8a720bfb2d3fe2d4f |
| institution | OA Journals |
| issn | 2688-1152 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-3e98c22677a64db8a720bfb2d3fe2d4f2025-08-20T02:08:23ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522021-10-0125n/an/a10.1002/emp2.12553Streptococcal pneumonia meningitis as an initial presentation of X‐linked agammaglobulinemia: A case report and discussionDaniel Kadden0Grace Fowler1Elissa Engel2Casey Logan3Kalyani Marathe4Craig Gosdin5UC College of Medicine, Department of Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USAUC College of Medicine, Department of Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USAUC College of Medicine, Department of Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USAUC College of Medicine, Department of Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USAUC College of Medicine, Department of Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USAUC College of Medicine, Department of Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USAAbstract X‐linked agammaglobulinemia (XLA) is a primary immunodeficiency caused by mutations in the gene for Bruton's tyrosine kinase (Btk), with affected males most commonly presenting with recurrent bacterial infections during the first few years of life. Here we present a 17‐month‐old male with a chief complaint of worsening rash and fever, whose history of streptococcal pneumonia meningitis at 5 months of age prompted suspicion for an underlying immunodeficiency and subsequent diagnosis of XLA. Bacterial meningitis is a rare initial presentation of XLA, and therefore physicians may easily overlook any underlying immunodeficiency. Prompt workup for immunodeficiency should be initiated in any vaccinated patient with a history of pneumococcal meningitis outside of the newborn period. Further discussion surrounding the various presentations of XLA, their related clinical manifestations and laboratory findings, and the importance of thorough chart review may encourage earlier diagnosis and initiation of treatment of this disease.https://doi.org/10.1002/emp2.12553absolute neutrophil countbacterial meningitisBruton's tyrosine kinaseecthyma gangrenosumStaphylococcus aureusX‐linked agammaglobulinemia |
| spellingShingle | Daniel Kadden Grace Fowler Elissa Engel Casey Logan Kalyani Marathe Craig Gosdin Streptococcal pneumonia meningitis as an initial presentation of X‐linked agammaglobulinemia: A case report and discussion Journal of the American College of Emergency Physicians Open absolute neutrophil count bacterial meningitis Bruton's tyrosine kinase ecthyma gangrenosum Staphylococcus aureus X‐linked agammaglobulinemia |
| title | Streptococcal pneumonia meningitis as an initial presentation of X‐linked agammaglobulinemia: A case report and discussion |
| title_full | Streptococcal pneumonia meningitis as an initial presentation of X‐linked agammaglobulinemia: A case report and discussion |
| title_fullStr | Streptococcal pneumonia meningitis as an initial presentation of X‐linked agammaglobulinemia: A case report and discussion |
| title_full_unstemmed | Streptococcal pneumonia meningitis as an initial presentation of X‐linked agammaglobulinemia: A case report and discussion |
| title_short | Streptococcal pneumonia meningitis as an initial presentation of X‐linked agammaglobulinemia: A case report and discussion |
| title_sort | streptococcal pneumonia meningitis as an initial presentation of x linked agammaglobulinemia a case report and discussion |
| topic | absolute neutrophil count bacterial meningitis Bruton's tyrosine kinase ecthyma gangrenosum Staphylococcus aureus X‐linked agammaglobulinemia |
| url | https://doi.org/10.1002/emp2.12553 |
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