Good syndrome combined with neutropenia and multiple microbial pulmonary infections: case report and review of the literature

Abstract

Introduction Good syndrome (GS) is a rare acquired immunodeficiency disease characterized primarily by thymoma and hypogammaglobulinemia that predisposes to the risk of recurrent infections with multiple pathogens. Case representation We describe the case of a 37-year-old male GS with a history of thymoma resection who was hospitalized for multiple pulmonary infections with neutropenia and whose empirical antimicrobial therapy and promotion of granulopoiesis resulted in the resolution of the pulmonary infections and return of the neutrophil count to normal. The patient was hospitalized again for lung infection with neutropenia. Experienced antimicrobial treatment and promotion of granulocytosis were ineffective, and the alveolar lavage fluid was detected by high-throughput sequencing (NGS) to be infected with Bordetella parapertussis, Streptococcus pneumoniae, cytomegalovirus, Torque teno virus, Candida albicans, and Pneumocystis jirovecii, and the patient's neutrophil counts returned to normal after targeted anti-infective treatment and immunity-enhancing therapy. After targeted anti-infection and immunity-boosting treatment, the patient's lung infection subsided and his neutrophil count normalized. Conclusion When patients with thymoma have recurrent abnormal infections, immunologic testing should be performed to clarify whether GS is present, and anti-infective therapy should be aggressively administered.