Chronic granulomatous disease in an adult with recurrent abscesses

Chronic granulomatous disease (CGD), produced by an inherited defect in the bactericidal capacity of polymorphonuclear neutrophils, is associated with recurrent abscess formation in regional lymph nodes, pulmonary parenchyma, and liver requiring surgical drainage. It is now becoming increasingly recognized that this is not a uniformly fatal disease of childhood. Instead, patients with milder forms of the disease are being detected during adulthood. General surgeons should be aware of the possibility of this diagnosis in a patient with recurrent pyogenic abscesses requiring drainage. Making the diagnosis of CGD is important because with chronic prophylactic antibiotic therapy and early aggressive treatment of recognized infections, the morbidity and mortality of patients can be favorably influenced. We describe a 27-year-old man with recurrent liver abscesses who was subsequently found to have CGD.