Recurrent Staphylococcal Abscesses Associated with Defective Neutrophil Chemotaxis and Allergic Rhinitis

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Abstract
Four patients with recurrent staphylococcal furunculosis and deep abscess formation were evaluated for a defect in the host defense mechanism accounting for the unusual incidence of infection. Each also suffered repeated allergic rhinitis, often preceding the onset of infection. A marked defect in neutrophil granulocyte chemotaxis occurred when the patients were symptomatic with rhinitis and abscess formation. Their mean chemotactic index (.+-.SD) was 16 .+-. 6; that of 25 control subjects was 70 .+-. 11. Neutrophil random migration, phagocytosis, bactericidal activity, and lymphocyte T[thymus derived]-cell populations were normal, as were serum concentrations of IgA [immunoglobulin A], IgG, IgM and IgE. Serial neutrophil function tests revealed normal chemotactic responsiveness when the patients were symptom-free of allergic rhinitis and no longer having abscesses. Abnormal function returned when symptoms recurred. These studies suggest that defective neutrophil function associated with allergic phenomena need not be accompanied by hyperimmunoglobulinemia E. Such defects may be intermittent, appearing when allergic symptomatology and infections develop.