Type A immunoglobulin deficiency presenting as a mixed polymicrobial brain abscess: case report

Subphrenic abscess and recurring focal lesions due to tuberculosis in a patient with IgA deficiency

Subdiaphragmatic abscess has not yet been reported as a manifestation of tuberculosis. We report an IgA deficient patient with recurrent episodes of unusual extrapulmonary manifestations of tuberculosis including subdiaphragmatic abscesses and metacarpophalangeal osteomyelitis that was improved each time with antituberculosis drugs. There was not any resistance to the drugs used against mycobacterium despite repeated courses of antituberculosis regimens. In such recurrent cases, one should rule out any immunodeficiency states.

Sonographic detection of multiple brain abscesses in a newborn with IgA deficiency

We report the case of a neonate with selective IgA deficiency and multiple brain abscesses diagnosed with sonography. Brain sonography revealed multiple abscesses in the left hemisphere; the abscesses ranged from 10 to 20 mm. Cultures obtained from the cerebrospinal fluid and blood were positive for Proteus mirabilis. The neonate responded promptly to broad-spectrum antibiotic therapy and had no neurologic sequelae. Because IgA deficiency is associated with infections, we believe it was a predisposing factor for the brain abscesses.