Acquired immunodeficiency associated with thymoma: a case report.

Area of Science:

• Immunology
• Oncology
• Infectious Diseases

Background:

• Acquired immunodeficiency associated with thymoma is a rare clinical condition.
• Thymoma, a tumor of the thymus gland, can impair immune function.
• This case presents an unusual immunodeficiency pattern with low CD4+ T-cell counts and normal gammaglobulin levels.

Observation:

• A 70-year-old male with a history of unresectable thymoma developed severe symptoms including fever, headache, and nausea.
• The patient presented with signs of meningitis and oropharyngeal candidiasis.
• Cerebrospinal fluid and blood cultures identified Listeria monocytogenes, leading to a diagnosis of Listeria meningitis.

Findings:

• The patient exhibited a significantly low CD4+ T-cell count (108 cells/μl) despite normal immunoglobulin levels.
• The low CD4+ T-cell count persisted post-discharge.
• Successful treatment with intravenous antibiotics led to full recovery from Listeria meningitis.

Implications:

• Physicians should consider acquired immunodeficiency in patients with thymoma, even with normal immunoglobulin levels.
• Low CD4+ T-cell counts in thymoma patients may predispose them to severe opportunistic infections like Listeria meningitis.
• Increased clinical awareness and diagnostic vigilance are essential for managing infections in immunocompromised thymoma patients.