Use of IgM- and IgA-Enriched Immunoglobulin Therapy in a Child With Methicillin-Resistant Staphylococcus aureus Sepsis

Intravenous immunoglobulins (IVIGs) are a cornerstone of immunologic therapy in pediatric conditions. Particular attention has been directed toward IgM- and IgA-enriched IVIG (IGAM), a formulation that differs from conventional IVIG because of its greater immunomodulatory activity. We describe a clinical case in which early immunomodulatory therapy with enriched immunoglobulins resulted in a favorable outcome. A 12-year-old boy presented to the pediatric emergency department with a 2-day history of fever and difficulty walking. Examination revealed pain on movement of the left lower limb and a warm, swollen, tender left knee with cutaneous hyperesthesia. Laboratory tests showed elevated inflammatory markers. Magnetic resonance imaging demonstrated a collection in the popliteal region extending to the left thigh, involving the vastus medialis muscle. Blood cultures were positive for methicillin-resistant Staphylococcus aureus . The patient received antibiotic therapy and Pentaglobin. This case suggests that early IGAM infusion in patients with infectious hyperinflammation may represent an effective therapeutic strategy.