chronic gr

Apuntes

chronic granulomatous disease (CGD), which presents with immunodeficiency, normal immunoglobulin levels and B/T cell counts, and multiple granulomas. The bronchoalveolar lavage fluid here shows branching septate hyphae at a narrow angle consistent with Aspergillus. Patients with CGD are at risk for infections with Staphylococcus aureus, Burkholderia cepacia complex, Serratia marcescens, Nocardia species, and Aspergillus species. Recurrent abscesses in the setting of normal T-cell, natural killer cell, and immunoglobulin levels suggest that the immunodeficiency involves the phagocytic system. The differential diagnosis for a phagocytic immunodeficiency includes leukocyte adhesion deficiency (LAD), Chediak-Higashi syndrome, CGD, and cyclic or congenital neutropenia. Granulomas are a characteristic finding of CGD but are not associated with the other phagocytic immunodeficiencies. In addition to pulmonary infectious complications (pneumonia, empyema, lung abscess), patients with CGD have the propensity to develop non-pulmonary infectious abscess formation (eg, perirectal abscess, liver, or anus) or infections in the gums, mouth, intestine, or ears. CGD is caused by a genetic defect th...