A 7-Month-Old Boy Is Brought to the Physician by His

A 7-month-old boy is brought to the physician by his parents due to irritability and white patches in his mouth.  His past medical history is significant for 3 episodes of otitis media and 2 episodes of bronchiolitis that have required hospitalization.  He also has a history of chronic loose stools.  The child is small for his age and ill-appearing.  Head and neck examination shows white patches consistent with oral candidiasis but is otherwise normal.  Auscultation of the lungs shows expiratory wheezing.  Cardiac examination is within normal limits.  Laboratory results are as follows: Serum protein electrophoresis shows a very low gamma globulin level.  Chest x-ray reveals an absent thymic shadow.  Which of the following is the most likely diagnosis?

A) Common variable immunodeficiency
B) DiGeorge syndrome
C) Severe combined immunodeficiency
D) Wiskott-Aldrich syndrome
E) X-linked agammaglobulinemia

Correct Answer:

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