Simultaneous Streptococcus pneumoniae, Giardia lamblia and Campylobacter pylori infection: an adult presentation of X-linked hypogammaglobulinaemia.

Primary X-linked (Bruton's) hypogammaglobulinaemia is uncommon. It usually presents clinically within the first two years of life--typically after the age of three months when maternal IgG is exhausted. Its diagnosis in middle life is exceptional. The presentation of the condition as a triple infection in a middle-aged man therefore seemed worthwhile reporting, as effective and safe prophylactic immunotherapy is now available.