title: Chronic granulomatous disease mimicking early-onset Crohn's disease with cutaneous manifestations.
abstract: BACKGROUND
  Chronic granulomatous disease is a rare inherited disorder of the innate immune system. In patients with a clinical history of recurrent or persistent infections, especially infections caused by uncommon species, chronic granulomatous disease should be considered.
  
  
  METHODS
  We report the case of a 5-year-old boy with a presumptive diagnosis of Crohn's disease with extraintestinal manifestations. Chronic granulomatous disease was suspected in this case after Serratia marcescens was isolated from a skin ulcer culture. Granulomas were confirmed on histology and chronic granulomatous disease was diagnosed.
  
  
  CONCLUSIONS
  This case emphasizes the importance of high clinical suspicion of an alternative diagnosis of immune deficiency in patients with presumed inflammatory bowel disease and opportunistic infections, especially when disease occurs in early life.
authors.forename: Maria
authors.initials: M
authors.lastname: Barbato
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ragusa
authors.forename: Fortunata
authors.initials: F
authors.lastname: Civitelli
authors.forename: Adriana
authors.initials: A
authors.lastname: Marcheggiano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Nardo
authors.forename: Metello
authors.initials: M
authors.lastname: Iacobini
authors.forename: Taulant
authors.initials: T
authors.lastname: Melengu
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cucchiara
authors.affiliation: Pediatric Immunology Unit, Sapienza University of Rome, Viale Regina Elena, 324-00161 Rome, Italy. melengu@hotmail.it.
authors.forename: Marzia
authors.initials: M
authors.lastname: Duse
mesh_terms: D002675:Child, Preschool; D003424:Crohn Disease / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006105:Granulomatous Disease, Chronic / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D016868:Serratia Infections / Q000175:diagnosis / Q000209:etiology*; D012706:Serratia marcescens / Q000302:isolation & purification*