ABSTRACT
Good syndrome (GS) is a rare acquired immunodeficiency disease characterized by the presence of thymoma with combined B and T cell immunodeficiency in adults. Recurrent bacterial infections, particularly sinopulmonary infections caused by encapsulated bacteria, remain the most common infective presentation of GS; however, relapsing viral infections have also been reported, likely due to impaired T cell-mediated immunity. Relapsing COVID-19 infection, however, has not been previously reported as a manifestation of GS. We present two cases of relapsing COVID-19 infection in patients with GS; in one case, relapsing COVID-19 was the first manifestation of newly diagnosed GS.
Subject(s)
COVID-19 , Immunologic Deficiency Syndromes , Primary Immunodeficiency Diseases , Thymoma , Thymus Neoplasms , Adult , Humans , Neoplasm Recurrence, Local , Thymus Neoplasms/diagnosis , Thymoma/complications , Thymoma/diagnosis , Immunologic Deficiency Syndromes/complications , Immunologic Deficiency Syndromes/diagnosisABSTRACT
The case was a 44-year-old patient with four years of evolution of respiratory infections, fever, weight loss of 30 kg and chronic diarrhea with inconclusive colonoscopy studies, managed as inflammatory bowel disease (IBD), with a history of thymomectomy four years previously. On physical examination, there was severe protein-calorie malnutrition, skin lesions compatible with herpes simplex infection and lower limb edema. Blood tests were requested when pancytopenia and hypoalbuminemia were negative for human immunodeficiency virus (HIV). Chest tomography showed a budding tree pattern and bronchiectasis, but SARS-CoV-2 was negative. A colonoscopy was performed, showing the presence of ulcers in the sigmoid colon with an infectious aspect vs IBD.