Abstract

To the Editor:— In the QUESTIONS AND ANSWERS section200:1190, 1967), there appears a case of chronic pulmonary infiltration in a 19-year-old boy. The presence ofHemophilus influenzaand staphylococcus in the sputum suggests some underlying pulmonary or systemic illness and Noehren in his reply mentions some possibilities. There are others that might be considered. Cystic fibrosis is present in about one of every 100 to 2,000 persons, the recessive gene being present in about one of every 16. Many dysgammaglobulinemias have been described (New Eng J Med275:709, 769, 1966). Another review of y-globulin deficiency presents a case of a 14-year-old boy with recurrent pneumonia whose sputum contained Hinfluenza. X-ray films of his nasopharynx showed a decreased amount of lymphoid tissue, and his serum μg globulin was only 170 mg/100 ml. Lastly, bronchiectasis is a possibility, even if acquired as a complication of some other underlying

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