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January 1990

Necrotizing Granulomatosis of the Spleen in Chronic Granulomatous Disease

Author Affiliations

Department of Pediatrics
Department of Pathology
Department of Pediatrics Washington University School of Medicine 400 S Kingshighway Blvd St Louis, MO 63110

Am J Dis Child. 1990;144(1):14-15. doi:10.1001/archpedi.1990.02150250016007

Sir.—Chronic granulomatous disease (CGD) is an inherited disorder of leukocyte bactericidal function that is characterized by chronic infections with widespread granulomatous lesions and recurrent abscess formation.1 Although recurrent abscess formation with granulomatous inflammation in multiple organs is the hallmark of this disease, review of the literature established splenic abscesses as a virtually unreported complication of CGD. We describe here splenic abscesses in a patient with CGD.

Patient Report.—A 14-year-old white boy with CGD required 17 admissions for recurrent abscesses (liver, rectum, and skin), pneumonia, osteomyelitis, and gastric outlet obstruction since 10 months of age. His disease was the X-linked type, lacking both the high- and low-molecular-weight subunits of cytochrome b558. The present admission was preceded by 3 weeks of fever and productive cough during which the patient was treated with oral amoxicillin with clavulanate potassium in addition to his regular regimen of trimethoprim with sulfamethoxazole and