Infectious Disease
Case 34: A Patient with Cough and Lymphocytosis
CASE
A 72‐year‐old woman presents acutely with fever and cough productive of green sputum. She is a non‐smoker. There is a history of frequent infections over the previous winter requiring antibiotics. Examination of the chest confirms infective signs in the right lower lobe and there are some small axillary lymph nodes.
Results obtained on this admission show a white blood count of 24.3 × 109/L (85% lymphocytes]); IgG is 2.9 g/L (normal range (NR) 6–16), IgA is 0.3 g/L (NR 0.65–3.0), IgM is <0.1 g/L (NR 0.75–2.4); serum electrophoresis shows a faint IgG kappa band and hypogammaglobulinaemia; and urine electrophoresis shows a trace of albumin.
QUESTION 1
Your score this session: 0 of 0
On the basis of these results, which is the most likely underlying diagnosis?