Severe bronchiectasis in a patient with common variable immunodeficiency

Eur Ann Allergy Clin Immunol. 2015 May;47(3):95-8.

Abstract

Background: Bronchiectasis are common in Common Variable Immunodeficiency. These patients are prone to infection, leading to progressive lung destruction and accelerated FEV1 decline.

Clinical case: 40 year-old man, with recurrent respiratory infections, autoimmunity and diarrhea since age 7. At 17 CVID was diagnosed and IVIgG was started. During the following years, respiratory symptoms progressively worsened and bronchiectasis was found on thoracic computed tomography. Bronchoscopy revealed Pseudomonas aeruginosa in bronchoalveolar lavage and bronchial secretions cultures. Eradication therapy led to clinical improvement.

Discussion: This case report stresses the importance of regular microbiological screening and appropriate antibiotherapy. Early/aggressive treatment may significantly impact on patients' evolution.

Keywords: CVID; Pseudomonas; bronchiectasis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Bronchiectasis / diagnosis
  • Bronchiectasis / drug therapy
  • Bronchiectasis / microbiology*
  • Bronchoalveolar Lavage Fluid / microbiology
  • Bronchoscopy
  • Common Variable Immunodeficiency / complications*
  • Common Variable Immunodeficiency / diagnosis
  • Common Variable Immunodeficiency / drug therapy
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Male
  • Pseudomonas Infections / diagnosis
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / microbiology*
  • Pseudomonas aeruginosa / isolation & purification*
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Immunoglobulins, Intravenous