Case history

Case history #1

A 1-year-old boy presents with a several-day history of decreased oral intake and activity, with new onset of fever. Past medical history is significant for two episodes of perirectal abscesses. Physical exam reveals a slightly ill-appearing child in no acute distress, with decreased breath sounds over the right upper lung field.

Case history #2

A 4-year-old girl born to consanguineous parents presents with a 3-day history of pain and swelling in the right neck. She is afebrile. Past medical history includes a soft tissue abscess at age 2, requiring incision and drainage. Culture of the lesion was positive for Staphylococcus aureus. Physical exam reveals a well-appearing child with a 3 cm x 2 cm slightly warm, tender right anterior cervical lymph node.

Other presentations

Uncommonly, chronic granulomatous disease (CGD) can present in the teenage and young adult years.[3][4]​ An uncommon cause of presentations is mycobacterial infections.[1][3][5]​ Chronic colitis (often diagnosed as inflammatory bowel disease) or symptoms of gastrointestinal (GI) or urinary tract obstruction may predate signs of infection.[6][7][8][9][10][11]​ In one study, 33% of patients were documented with GI disease and accompanying abdominal pain.[6] Liver abscesses caused by Staphylococcus aureus, especially if chronic or recurrent, suggest a diagnosis of CGD.[12]

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