Protracted necrotizing pharyngitis associated with an acquired defect of neutrophil chemotaxis in multiple myeloma

A 69-year-old man presented with protracted necrotizing pharyngitis requiring prolonged antibiotic therapy. During immunologic evaluation he was found to have IgA multiple myeloma, low complement component C1q and extrinsic defect of neutrophil chemotaxis. The severity of his pharyngitis correlated with myeloma activity implying a causal relationship. The characteristics of the illness strongly suggest that it is related to the acquired defect in neutrophil chemotaxis. This case represents a previously undescribed infectious complication of multiple myeloma.