title: An unusual case of sinusitis.
abstract: BACKGROUND
  Common Variable Immunodeficiency (CVID) is the commonest form of severe antibody deficiency. It is characterized by reduced levels of IgG (<400 mg/dL) and low IgA and/or IgM levels, recurrent bacterial infections, impaired antibody responses despite the presence of B Cells and normal or near normal T immunity in 60% of patients. There is a high mortality from infections without treatment. The main stay treatment is to replace the immunoglobulins.
  
  
  METHODS
  We describe a British soldier with a 10 year history of recurrent chest infections, sinusitis and otitis media. He repeatedly presented 2 to 3 times a year complaining of either a green nasal discharge or a cough productive of yellow/green sputum. He presented three years ago with severe sinusitis which resulted in investigations highlighting hypogammaglobulinaemia. Subsequently he was started on immunoglobulin therapy with Flebogamma 40 g three weekly.
  
  
  CONCLUSIONS
  Despite being a relatively rare condition, CVID when diagnosed, can be easily treated and improve patients' prognosis. Medical Officers should be aware of the condition as a differential diagnosis for individuals presenting with recurrent infections.
authors.affiliation: Chelsea and Westminister Hospital, 369 Fulham Road, London, SW10 9NH. lucybaker45@hotmail.com
authors.forename: L
authors.initials: L
authors.lastname: Lamb
authors.forename: P
authors.initials: P
authors.lastname: Richards
authors.forename: J D M
authors.initials: JD
authors.lastname: Edgar
mesh_terms: D000328:Adult; D001991:Bronchitis / Q000276:immunology; D017074:Common Variable Immunodeficiency / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D008889:Military Personnel; D010033:Otitis Media / Q000276:immunology; D012852:Sinusitis / Q000276:immunology*
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors