A 16-month-old infant was presented with shortness of a breath and severe cough. He had a medical history of otitis media and upper tract infection in the third month. Physical examination The infant appeared pale and thin. Height and weight were below the third centile.
Immunization (at 2, 3 and 4 months) with tetanus and diphtheria toxoids, whole-cell pertussis, Haemophilus conjugate vaccine and oral polio was carried out. Additionally, he received rubella vaccine at 12 th month. All immunizations were uneventful. Immunological investigation Quantitative serum immunoglobulins (g/l) IgG 0.18 (Normal range 5.5-10.0) IgA Not detected (Normal range 0.3-0.8) IgM 0.06 (Normal range 0.4-1.8) Blood lymphocyte subpopulations (x10 9 /l) Total lymphocyte count 3.5 (Normal range 2.5-5.0) T lymphocytes (CD3) 3.02 (Normal range 1.5-3.0) B lymphocytes (CD23) <0.03 (Normal range 0.1-0.4) CD19 <0.1…
