[Job's syndrome and miliary tuberculosis]

Area of Science:

• Immunology
• Infectious Diseases
• Genetics

Background:

• Hyper Immunoglobulin E syndrome (HIES), or Job's syndrome, is a rare primary immunodeficiency with autosomal dominant or recessive inheritance.
• HIES is characterized by elevated IgE, eosinophilia, eczema, recurrent infections (Staphylococcus aureus), and lung complications like pneumatoceles and bronchiectasis.
• While patient survival has improved, opportunistic infections and lymphomas remain concerns.

Observation:

• This report details a patient with HIES presenting with miliary tuberculosis and severe respiratory compromise.
• Few cases of Mycobacterium tuberculosis infection in HIES patients have been documented.

Findings:

• The patient with HIES and miliary tuberculosis responded positively to standard first-line anti-tuberculous treatment.
• This suggests that conventional anti-TB regimens are effective in managing tuberculosis in HIES patients.

Implications:

• This case highlights the importance of considering and managing tuberculosis in HIES patients.
• Effective treatment of tuberculosis in HIES can lead to positive patient outcomes, even in severe presentations.
• Further research into the interplay between HIES and mycobacterial infections is warranted.