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J Med Microbiol 56 (2007), 863-865; DOI: 10.1099/jmm.0.47046-0
© 2007 Society for General Microbiology
ISSN 1473-5644

Case Report

Recurrent infection with genetically identical pneumococcal isolates in a patient with interleukin-1 receptor-associated kinase-4 deficiency

Judit Szabó1, Orsolya Dobay2, Melinda Erdos3, Ágnes Borbély1, Ferenc Rozgonyi2 and László Maródi3

1 Department of Medical Microbiology, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary

2 Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary

3 Department of Infectious and Paediatric Immunology, Medical and Health Science Centre, University of Debrecen, Nagyerdei Krt 98, Debrecen H-4032, Hungary

Correspondence
László Maródi
lmarodi{at}jaguar.dote.hu

Received 2 November 2006
Accepted 22 February 2007

Interleukin-1 receptor-associated kinase (IRAK)-4 deficiency is a rare primary immunodeficiency disorder characterized by severe, invasive infections with Streptococcus pneumoniae. Using the PFGE technique a genetic linkage was found between two S. pneumoniae serotype 14 isolates causing arthritis and meningitis at 3 and 51/2; years of age, respectively, in a boy with IRAK-4 deficiency. This finding suggested that patients with IRAK-4 deficiency may harbour persistent strains of pneumococci. Alternatively, reinfection with strains from close contacts of the patient might cause recurrent invasive disease. It is proposed that eradication of pneumococci from the nasopharynx, and immunization of household contacts may prevent recurrent infection in IRAK-4-deficient patients.

Abbreviations: IPD, invasive pneumococcal disease; IRAK, interleukin-1 receptor-associated kinase.






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