{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T14:14:37Z","timestamp":1767795277197,"version":"3.49.0"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Immunology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Chronic granulomatous disease (CGD) is a primary immunodeficiency caused by defective phagocyte oxidative burst and may present in early life with severe or recurrent infections. We report a female infant born at 38 weeks\u2019 gestation (birth weight 2700\u2009g) who developed fever and presumed sepsis at 5 days of life, followed by multiple recurrent hospitalizations for febrile illness with suspected meningitis, diarrhea, dehydration, and failure to thrive. Cerebrospinal fluid (CSF) evaluations across episodes demonstrated pleocytosis with elevated protein and normal\u2010to\u2010low glucose, while Gram stain and CSF cultures were repeatedly negative, consistent with recurrent culture\u2010negative meningitis. Laboratory assessment showed intermittent anemia, thrombocytosis, and episodes of significant neutropenia. Complement and immunoglobulin levels were within reference ranges, and flow cytometry demonstrated preserved T\u2010 and B\u2010lymphocyte compartments. A flow cytometric dihydrorhodamine (DHR) oxidative burst assay was markedly abnormal (phorbol 12\u2010myristate 13\u2010acetate stimulation index 13%;\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    stimulation index 22.3%), supporting the diagnosis of CGD. At ~4.5 months of age, a sterile catheter urine culture grew multidrug\u2010resistant\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    at \u2265100,000\u2009CFU\/mL with susceptibility limited to aminoglycosides; the patient was treated with amikacin 15\u2009mg\/kg\/dose intravenously once daily for 10 days, with defervescence within 48\u2009h, clinical recovery, and a repeat urine culture showing no growth. Genetic testing was not performed due to financial and social constraints, and longer\u2010term outcomes beyond early infancy were unavailable in the record extract. This case underscores that recurrent culture\u2010negative meningitis in early infancy should prompt evaluation for primary immunodeficiency and that early DHR testing can expedite CGD diagnosis and guide timely preventive management and specialist referral.\n                  <\/jats:p>","DOI":"10.1155\/crii\/1817159","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T11:21:10Z","timestamp":1767784870000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neonatal\u2010Onset Chronic Granulomatous Disease Presenting With Recurrent Culture\u2010Negative Meningitis: A Case Report and Diagnostic Considerations"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1921-4328","authenticated-orcid":false,"given":"Anwar Abu","family":"Hetta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4187-4937","authenticated-orcid":false,"given":"Rayyan G.","family":"Shakarnah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4204-3896","authenticated-orcid":false,"given":"Khalil R.","family":"Salah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9683-7257","authenticated-orcid":false,"given":"Jasem Y.","family":"Hroub","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7356-9617","authenticated-orcid":false,"given":"Abdallah N.","family":"Khatib","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0938-8131","authenticated-orcid":false,"given":"Amjad H.","family":"Rabei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"crossref","DOI":"10.1007\/s12325-017-0636-2","article-title":"A Review of Chronic Granulomatous Disease","volume":"34","author":"Arnold D. 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