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Uncommon Cause of Hemoptysis in a 15-Year-Old Boy

Cristina de Manuel Gómez1, Sonia Milkova Ivanova2, Teresa Del Rosal3

  • 1Pediatric Pulmonology Department, Hospital Universitario La Paz, Madrid, Spain.

Chest
|October 9, 2022
PubMed
Abstract

Insights

A 15-year-old boy with recurrent infections, including pneumonia and abscesses, experienced hemoptysis. Further investigation ruled out chronic granulomatous disease, suggesting other immune deficiencies may be involved.

Area of Science:

  • Pediatric Pulmonology
  • Immunology
  • Infectious Diseases

Background:

  • A 15-year-old male with a history of necrotizing pneumonia, lung abscess, recurrent perianal abscesses, and chronic otitis media presented with hemoptysis.
  • Family history revealed paternal history of recurrent skin abscesses and methicillin-resistant Staphylococcus aureus (MRSA) carriage.

Observation:

  • The patient experienced three acute episodes of self-limited hemoptysis.
  • Previous medical history included a right upper lobe lung abscess with residual pneumatocele.
  • Recurrent suppurative otitis media, despite surgical intervention, yielded methicillin-sensitive Staphylococcus aureus (MSSA).

Findings:

  • Neutrophil oxidative burst testing excluded chronic granulomatous disease (CGD).
  • Immunoglobulin levels and lymphocyte populations were within normal limits.
  • The patient's clinical presentation and family history suggested a potential underlying immunodeficiency.

Implications:

  • This case highlights the importance of a comprehensive evaluation for immunodeficiency in pediatric patients with recurrent severe infections and hemoptysis.
  • Further investigation into specific immune pathways may be warranted to identify the underlying cause.
  • Understanding genetic predispositions to recurrent Staphylococcus aureus infections is crucial for effective management.

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