A 6 months old boy presented with fever and cough for 7 days and breathlessness for 2 days. He had been hospitalized 3 times in the past for fever and cough and had been treated with IV antibiotics and nebulization for the same. Father had tuberculosis and was on treatment for 2 months. Child's Chest X-Ray showed right parahilar haziness, mantoux test was 16 mm. HIV ELISA was negative. The child was treated with antituberculous therapy (ATT) & salbutamol nebulization to which he responded. In view of recurrent hospitalizations for respiratory infections, he was worked up:
• Sweat Chlorides = Normal • Echocardiogram = Normal • Milk scan = No GER • HRCT Chest = Right lower lobe consolidation with perihilar necrotic lymphnodes • Serum immunoglobulins = Elevated serum IgE (721 IU/dl) and normal serum IgG, IgA & IgM.