26malik
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A four-year-old boy is brought to the pediatrician because of several "boils" on his arm.His mother tells the physician that the boy has had similar lesions on several previous occasions that were treated successfully with antibiotics. She denies any history of eczema or typical childhood illnesses such as measles or chicken pox. The child has had all of his immunizations. Laboratory examination reveals a normal complete blood count, immunoglobulin levels, B cell and T cell counts, and complement levels. Serum calcium and parathyroid hormone levels are also normal. The nitroblue tetrazolium test is negative. Which of the following diagnoses is most consistent with these data?
A. Bruton's agammaglobulinemia
B. Chronic granulomatous disease
C. DiGeorge syndrome
D. SCID (severe combined immunodeficiency disease)
E. Wiskott-Aldrich syndrome
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| robin082006
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B
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| general malaise
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B...boils probably due to staph aureus
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| doc179
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| 26malik
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B
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| yasmeen
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B
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| DrVirgo
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A negative nitrobluetetrazolium test in this case indicates that there is NO oxidative burst (NADPH Oxidase), which means he has CGD. so therefore the kid is at risk of getting infections with catalase positive organisms like Staph which causes boils.
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| summer
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yes, B. the clue is the nitrobluetetrazolium test.
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| waqastariq
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CGD dude ! thats what Dr. Goljan says 
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| mjl1717
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there are many clues:
1) hormal B cells r/o Brutons
2) normal para thyroid r/o DiGeorge
3) no ezema r/o Wiskott Aldrich (these are most like r/o's)
4)SCID is T &B cell def with Opportunistic infections
5)only CGD is left
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