Chronic granulomatous disease carrier with recurrent poor obstetric outcome

Chronic granulomatous disease is a primary immunodeficiency disorder characterized by severe recurrent bacterial and fungal infections. Female carriers of the X-linked form of the disorder usually are unaffected and rarely have serious infections.

A 22-year-old pregnant patient known to be a carrier of the X-linked form of chronic granulomatous disease had a history of chorioamnionitis during her two previous pregnancies. During her third pregnancy, she presented again with the same diagnosis, which resulted in delivery at 25 weeks of gestation.

Carriers of chronic granulomatous disease should be monitored closely during pregnancy, as if they have the disease. To decrease the risk of infectious morbidity and mortality, obstetricians should have a low threshold for starting prophylactic antibiotics early during pregnancy, even if the patient is asymptomatic.