[Pubmed] Thymoma: a fatal case report of recurring pneumonia from Tanzania

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Ann Med Surg (Lond). 2023 Mar 27;85(4):1018-1021. doi: 10.1097/MS9.0000000000000300. eCollection 2023 Apr.

ABSTRACT

Thymomas present either concurrently with myasthenia gravis, with local pressure symptoms, or asymptomatically as a mediastinal mass. Due to its variable presentation, the incidence is low, as not all cases would be identified. Thymomas can present with a rare entity of combined T-cell and B-cell immunodeficiency in adults. Thymectomy is the most important prognostic factor, including preventing autoimmune manifestations of thymoma, but immunodeficiency may persist after thymectomy.

CASE PRESENTATION: The authors report a case of thymoma with evidence of immunodeficiency, manifesting as recurrent pneumonia and respiratory distress in an HIV-seronegative 62-year-old man with a suspected diagnosis 3 years before admission. During his bouts of pneumonia, blood cultures revealed methicillin-resistant Staphylococcus aureus, which was initially treated with vancomycin and then with clindamycin. Although hypogammaglobulinemia was not established in our low-resource setting, there was a reduced CD4-cell count with an abnormal CD4/CD8 ratio. The patient responded well to the first course of antibiotics. However, the second attempt was unsuccessful, which led to his demise.

CONCLUSION: Clinicians should be aware that thymoma can cause immunodeficiency. Clinical suspicion should be raised in patients who present with recurrent infections, particularly in thymoma cases with adult-onset immunodeficiency.

PMID:37113973 | PMC:PMC10129280 | DOI:10.1097/MS9.0000000000000300


Source: https://pubmed.ncbi.nlm.nih.gov/3711397 ... t6+86293ac