Case report
Haemophilus influenzae pneumonia and immunodeficiency in association with thymoma–A presentation of Good's Syndrome
Pneumonia por Haemophilus Influenzae e imunodeficiência associadas a timoma–uma apresentação da Síndrome de Good
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Lopes, C. Gomes, N. Diogo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "Lopes" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Gomes" ] 2 => array:2 [ "nombre" => "N." "apellidos" => "Diogo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511511000479?idApp=UINPBA00004E" "url" => "/21735115/0000001700000006/v1_201305151553/S2173511511000479/v1_201305151553/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "<span class="elsevierStyleItalic">Haemophilus influenzae</span> pneumonia and immunodeficiency in association with thymoma–A presentation of Good's Syndrome" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "272" "paginaFinal" => "274" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Fahim, M. Abuzakouk, S.P. Hart" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Fahim" "email" => array:1 [ 0 => "ahmedfahim@doctors.org.uk" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Abuzakouk" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "S.P." "apellidos" => "Hart" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Division of Cardiovascular and Respiratory Studies, Castle Hill Hospital, Castle Road, Cottingham, United Kingdom" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Immunology, Hull Royal Infirmary, Anlaby Road, Hull, United Kingdom" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Pneumonia por Haemophilus Influenzae e imunodeficiência associadas a timoma–uma apresentação da Síndrome de Good" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec161701" "palabras" => array:3 [ 0 => "Respiratory infections" 1 => "Immunodeficiency" 2 => "Thymoma" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras chave" "identificador" => "xpalclavsec161702" "palabras" => array:3 [ 0 => "Infecções respiratórias" 1 => "Imunodeficiência" 2 => "Timoma" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Good's Syndrome is a rare cause of immunodeficiency associated with thymoma. Patients with this syndrome are prone to infections with encapsulated microorganisms. The diagnosis may be delayed for a considerable time period even after the thymectomy. Case presentation: We describe the case of a 70-year-old woman with a background of thymec-tomy who presented with pneumonia and gram negative sepsis. Haemophilus influenzae was found in blood cultures. Moreover, there was evidence of impaired B and T cell immunity con-sistent with Good's Syndrome. She was commenced on immunoglobulin replacement following treatment of sepsis and remains well 18 months after the initial presentation.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">This case illustrates the importance of considering Good's Syndrome in the con-text of pneumonia and immunodeficiency associated with encapsulated organisms such as Haemophilus influenzae. This clinical entity is associated with a significant mortality and should be considered as a cause of immunodeficiency even years after thymectomy.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Introdução: A Síndrome de Good é uma causa rara da imunodeficiência associada ao timoma. Os pacientes com esta síndrome são propensos a infecções por microrganismos encapsulados. O diagnóstico pode ser atrasado por bastante tempo, mesmo após a timectomia. Apresentação do Caso: Descrevemos o caso de uma mulher de 70 anos com antecedentes de timectomia, que apresentava pneumonia e sepsis por agente gram negativo. O Haemophilus influenzae foi isolado em hemoculturas. Além disso, evidência de alterações da imunidade celular B e T, consistente com a Síndrome de Good. A doente iniciou terapêutica de substituição com imunoglobulina seguida de tratamento da sepsis e continua bem 18 meses após a apresentação inicial. Conclusão: Este caso ilustra a importância de considerar a Síndrome de Good no contexto da pneumonia e imunodeficiência associadas a organismos encapsulados, como Haemophilus influenzae. Esta entidade clínica está associada a uma mortalidade significativa e deve ser considerada como uma causa de imunodeficiência mesmo anos depois da timectomia.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "[1]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Agammaglobulinaemia–a provocative experiment of nature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.A. Good" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Bull Univ Minnesota." 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