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Achromobacter xylosoxidans Sepsis Unveiling X-linked Agammaglobulinemia Masquerading as Systemic-onset Juvenile Idiopathic Arthritis

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Abstract

Background

X-linked agammaglobulinemia, a primary immunodeficiency, can present with musculoskeletal manifestations.

Case characteristics

A 4-year-old boy, diagnosed as systemic juvenile idiopathic arthritis at the age of 3 years and treated with biological agents, presented with fever, dyspnea and chest pain. Blood culture and pericardial fluid culture revealed Achromobacter xylosoxidans.

Outcome

Investigation revealed normal serum ferritin but low levels of serum immunoglobulins. Further immunological work-up revealed diagnosis of X-linked agammaglobulinemia. Child improved on antibiotic therapy; treatment with steroids and biological was discontinued.

Message

Underlying immunodeficiency disease must be looked for in children suspected to have juvenile arthritis, more so if they develop unusual serious infection in response to immunomodulatory therapy.

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Author information

Authors and Affiliations

  1. Division of Pediatric Rheumatology, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, India

    Mahesh Janarthanan

  2. Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, India

    Sameera Gollapalli & Shuba Sankaranarayanan

Authors
  1. Mahesh Janarthanan
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  2. Sameera Gollapalli
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  3. Shuba Sankaranarayanan
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Correspondence to Mahesh Janarthanan.

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Janarthanan, M., Gollapalli, S. & Sankaranarayanan, S. Achromobacter xylosoxidans Sepsis Unveiling X-linked Agammaglobulinemia Masquerading as Systemic-onset Juvenile Idiopathic Arthritis. Indian Pediatr 56, 423–425 (2019). https://doi.org/10.1007/s13312-019-1541-3

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  • DOI: https://doi.org/10.1007/s13312-019-1541-3

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