Good's Syndrome-A Rare Cause of Acquired Adult Immunodeficiency: A Case Report.

Human immunodeficiency virus (HIV)-negative acquired adult immunodeficiency diseases are rare and relatively difficult to diagnose and treat. Good's syndrome is one such rare immunodeficiency syndrome occurring in middle to late adulthood. It is an association of combined B-cell and T-cell immunodeficiency along with hypogammaglobulinemia with a background of thymoma. Here, we describe a case of a 57-year-old male who presented to us with recurrent streptococcal pneumonia. He had a past history of an operated thymoma, cytomegalovirus retinitis, and pure red cell aplasia (PRCA). Evaluation revealed hypogammaglobulinemia along with CD4+ T-cell and B-cell lymphopenia, thus indicating Good's syndrome. Our case highlights the importance of including Good's syndrome in the differential diagnosis of HIV-negative, acquired, adult immunodeficiency and elucidates the general principles of management of this rare clinical entity.