title: Recurrent infection with genetically identical pneumococcal isolates in a patient with interleukin-1 receptor-associated kinase-4 deficiency.
abstract: Interleukin-1 receptor-associated kinase (IRAK)-4 deficiency is a rare primary immunodeficiency disorder characterized by severe, invasive infections with Streptococcus pneumoniae. Using the PFGE technique a genetic linkage was found between two S. pneumoniae serotype 14 isolates causing arthritis and meningitis at 3 and 5(1/2) years of age, respectively, in a boy with IRAK-4 deficiency. This finding suggested that patients with IRAK-4 deficiency may harbour persistent strains of pneumococci. Alternatively, reinfection with strains from close contacts of the patient might cause recurrent invasive disease. It is proposed that eradication of pneumococci from the nasopharynx, and immunization of household contacts may prevent recurrent infection in IRAK-4-deficient patients.
authors.affiliation: Department of Medical Microbiology, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Szabó
authors.affiliation: Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Orsolya
authors.initials: O
authors.lastname: Dobay
authors.affiliation: Department of Infectious and Paediatric Immunology, Medical and Health Science Centre, University of Debrecen, Nagyerdei Krt 98, Debrecen H-4032, Hungary.
authors.forename: Melinda
authors.initials: M
authors.lastname: Erdős
authors.affiliation: Department of Medical Microbiology, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary.
authors.forename: Ágnes
authors.initials: Á
authors.lastname: Borbély
authors.affiliation: Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Rozgonyi
authors.affiliation: Department of Infectious and Paediatric Immunology, Medical and Health Science Centre, University of Debrecen, Nagyerdei Krt 98, Debrecen H-4032, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Maródi
mesh_terms: D001168:Arthritis / Q000382:microbiology; D002648:Child; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications; D053592:Interleukin-1 Receptor-Associated Kinases / Q000172:deficiency* / Q000276:immunology; D008297:Male; D008581:Meningitis / Q000382:microbiology; D017720:Molecular Epidemiology; D011008:Pneumococcal Infections / Q000276:immunology / Q000382:microbiology*; D012008:Recurrence; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D004269:DNA, Bacterial; C507773:IRAK4 protein, human; D053592:Interleukin-1 Receptor-Associated Kinases