[Partial deficiency of cell-mediated immunity in a child with chronic mucocutaneous candidiasis. Intercurrent meningeal and pulmonary cryptococcosis].
The authors report a new case of partial immune deficiency of cellular immunity, associated with chronic mucocutaneous candidiasis in a 12 Years-old boy. The disease began very early during the first few weeks of life, with thrush in the mouth. This candidiasis then evolved intermittently and was still present. Numerous cutaneous, pulmonary and ear infections occured throughout this child's life. This morbid association led to a search for an immune deficiency. Humoral immunity was normal. Abnormalities of cellular immunity were as follows: apart from candidine skin anergy, there was a deficiency in the factor which inhibits leukocyte migration, secretion of a factor favouring this migration (MEF). It was also noted the presence of the patient's serum, of a factor inhibiting lymphocyte transformation in the presence of candidine. In spite of treatment with intravenous route, amphotericin B, followed by transfer factor, the oral candidiasis persisted together with the skin anergy to candidine. On the other hand, the serum inhibitory factor disappeared. Pulmonary cryptococcosis probably favoured by corticosteroid treatment, developed on this background of immune deficiency; as usual it spread to the meninges. Treatment associating intraveinous amphotericin B and 5 fluorocytosine oral and later intravenous, total duration 6 months, grave a recovery maintained on a 8 months follow up.
D000666:Amphotericin B / Q000627:therapeutic use; D002179:Candidiasis, Cutaneous / Q000188:drug therapy / Q000276:immunology*; D002648:Child; D002908:Chronic Disease; D003453:Cryptococcosis / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007111:Immunity, Cellular; D007153:Immunologic Deficiency Syndromes / Q000150:complications*; D008172:Lung Diseases, Fungal / Q000150:complications*; D008297:Male; D008581:Meningitis / Q000150:complications*; D009761:Nystatin / Q000627:therapeutic use
D009761:Nystatin; D000666:Amphotericin B
Déficit partiel de l'immunité à médiation cellulaire chez un enfant atteint de candidose cutanéomuqueuse chronique. Cryptococcose pulmonaire et méningée intercurrente