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Disseminated Penicilliosis, Recurrent Bacteremic Nontyphoidal Salmonellosis, and Burkholderiosis Associated with Acquired Immunodeficiency Due to Autoantibody against Gamma Interferon

2010; American Society for Microbiology; Volume: 17; Issue: 7 Linguagem: Inglês

10.1128/cvi.00053-10

1556-6811

Bone Siu-Fai Tang, Jasper Fuk‐Woo Chan, Min Chen, Owen Tak‐Yin Tsang, M.Y. Mok, Raymond Wai‐Man Lai, Rodney Lee, Tak‐Lun Que, Herman Tse, Iris Wai-Sum Li, Kelvin Kai‐Wang To, Vincent Chi‐Chung Cheng, Eric Yuk-Tat Chan, Bo‐Jian Zheng, Kwok‐Yung Yuen,

Autoimmune Bullous Skin Diseases

Acquired immunodeficiency due to autoantibody against gamma interferon has recently been associated with opportunistic nontuberculous mycobacteriosis, especially among Southeast Asians. We report another 8 cases, all except one apparently immunocompetent hosts who suffered from concomitant or sequential infections by other intracellular pathogens causing penicilliosis, extraintestinal nontyphoidal salmonellosis, and burkholderiosis. The only case with an underlying immunodeficiency syndrome had systemic lupus erythematosus that was quiescent throughout the multiple infective episodes. Eight out of 10 (80.0%) patients with serological evidence of penicilliosis, 5 out of 7 (71.4%) with culture-positive extraintestinal nontyphoidal salmonellosis, 5 out of 28 (17.9%) with serological evidence of melioidosis, and 7 out of 13 (53.8%) with culture-positive nontuberculous mycobacteriosis possessed autoantibody against gamma interferon, whereas only 1 out of 100 patients with systemic lupus erythematosus did. Our study represents the first and largest case series linking this emerging immunodeficiency syndrome with these atypical infections in apparently immunocompetent hosts. Thus, we advocate that any patient with unexplained recurrent or polymicrobial infections due to these intracellular pathogens should be screened for acquired immunodeficiency due to autoantibody against gamma interferon.