PDF(Pubmed)
Abstract：
Common variable immunodeficiency (CVID) is the most common humoral immune deficiency in adults, characterized by recurrent sinopulmonary bacterial infections. Invasive fungal infections are rarely associated with CVID. Late-onset combined immunodeficiency (LOCID) is a recently recognized variant of CVID with low CD4 counts and immunoglobulins deficiency. The current study reveals the first documented case of invasive pulmonary aspergillosis (Aspergillus terreus) in a patient with LOCID. A 52-year-old female with a recurrent history of sinopulmonary infections presented with acute onset fever and shortness of breath. Blood culture and bronchoalveolar lavage culture grew A. terreus. Further evaluation revealed low immunoglobulins (IgG, IgM and IgA). Moreover, she also had low CD4 counts (<200 cells/µL). The patient was successfully treated with voriconazole and immunoglobulin therapy. Finally, the study discusses LOCID as a potential risk factor for invasive fungal infections, which can be easily overlooked and cause poor outcomes.
摘要：
常见可变免疫缺陷(CVID)是成人中最常见的体液免疫缺陷,以反复鼻肺细菌感染为特征。侵袭性真菌感染很少与CVID相关。迟发性联合免疫缺陷（LOCID）是最近公认的CVID变体，具有低CD4计数和免疫球蛋白缺乏。当前的研究揭示了患有LOCID的患者中第一例有记录的侵袭性肺曲霉病（土曲霉）。一名52岁女性，有反复的鼻肺感染史，表现为急性发作发热和呼吸急促。血培养和支气管肺泡灌洗培养生长地鼠。进一步评估显示低免疫球蛋白（IgG，IgM和IgA）。此外，她的CD4计数也较低(<200细胞/微升).患者成功接受伏立康唑和免疫球蛋白治疗。最后,该研究讨论了LOCID作为侵袭性真菌感染的潜在危险因素，这很容易被忽视，导致糟糕的结果。
