Immune Deficiency and Deep Abscesses

Introduction: Immunodeficiency remains a rare condition. The most often revealing manifestations in children are infections, but other presentations are possible. We report 4 cases of immune deficiency associated with deep abscesses.

Methods: Retrospective study of cases of immunodeficiency associated with a deep abscess, admitted to the pediatric department of Sahloul hospital Sousse Tunisia.

Results: Two girls and two boys were gathered. The age of onset of immunodeficiency was less than 1 year in all cases with an average age of 6 months (2 to 10 months). Immune deficiency was Buckley syndrome (n = 3) and IgG and IgA deficiency (n = 1).

The associated abscess was psoas abscess (n = 2), adenophlegmon (n = 1), and soft tissue phlegmon (n = 1).

The clinical signs suggestive of the abscess were mainly fever (n = 4), swelling (n = 4) and lymphadenopathy (n = 2).

The isolated organisms were Staphyloccoccus aureus (n = 3) and Pseudomonas aeruginosa (n = 1). The evolution was favorable with disappearance of the abscess under adapted antibiotherapy.

Surgical treatment: surgical drainage, was associated in 2 cases. Two cases of recidivism were noted. The diagnosis of immune deficiency was based on recurrence of abscess (n = 2), association with recurrent bronchopulmonary infections (n ​​= 1) or association with severe disseminated infection (n = 1).

Conclusion: The association of immunodeficiency and abscess is rare. The treatment is based on a suitable antibiotherapy associated in some cases with surgical drainage. Specific therapy for immune deficiency helps to prevent recurrence.