CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1592152
A case report of septic shock caused by Opportunistic Infections Associated with Anti-Interferon-γ Autoantibody Positivity: diagnostic and therapeutic challenges
Provisionally accepted
- Zhujiang Hospital, Southern Medical University, Guangzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background Since 2004, there has been an increasing number of reports on severe, persistent, or recurrent Salmonella infections in adults with adult immunodeficiency associated with anti-gamma interferon antibody positivity (AIGA). AIGA patients experience rapid disease progression upon infection with opportunistic pathogens, high mortality rates, and strong disease latency, posing significant challenges for diagnosis and treatment. This article discusses the diagnosis and treatment strategies for AIGA with opportunistic pathogen infection through the diagnosis and treatment process of a 61-year-old male patient. Methods The patient presented with diarrhea and fever for 2 weeks and was diagnosed with non-typhoidal Salmonella infection at an external hospital. The condition progressed to shock and the patient was transferred to our EICU. After admission, the pathogens were confirmed through chest CT, blood culture, blood metagenomic next-generation sequencing (mNGS), and bronchoalveolar lavage fluid (BALF) mNGS, and cell immune function screening and anti-gamma interferon antibody testing were completed. The anti-infective treatment regimen was adjusted based on the test results, and immunoglobulin therapy was administered. Results The patient's blood culture was positive for non-typhoidal Salmonella, and blood mNGS confirmed non-typhoidal Salmonella and Legionella pneumophila; BALF mNGS showed Enterococcus faecium, Legionella pneumophila, Candida tropicalis, Candida glabrata, HSV1, and CMV mixed infection. Immune function screening indicated a significant decrease in CD4+ T cells (303 cells/μL) and a significant increase in anti-gamma interferon antibody (163.78 ng/mL), confirming the diagnosis of AIGA. After treatment with meropenem, linezolid, doxycycline, ganciclovir, and caspofungin combined with anti-infective and immunoglobulin therapy, the patient's condition significantly improved and was discharged. Conclusion AIGA patients experience rapid disease progression after infection with opportunistic pathogens. Early identification of anti-gamma interferon antibody and mixed infection pathogens is crucial for treatment.
Keywords: anti-interferon-γ autoantibody positivity, Adult-onset immunodeficiency syndrome, Non-typhoidal Salmonella, extraintestinal dissemination, diagnostic and therapeutic thinking
Received: 12 Mar 2025; Accepted: 12 May 2025.
Copyright: © 2025 Fan, Tang, Shao, Xu and Xie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yiqi Fan, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Waijiao Tang, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.