Too much diarrhoea, too many infections, and too few neutrophils

Neutropenia is a common finding in ill paediatric patients and can be conveniently subdivided into that due to decreased production or increased destruction. Intrinsic defects in granulocytes or their progenitors or extrinsic factors such as infection, drugs and autoimmune phenomena are the main causes. Our case focuses on cyclic neutropenia presenting with severe chronic diarrhoea lasting 17 weeks, multiple recurrent bacterial infections and pulmonary tuberculosis (TB). To our knowledge this is the first case of pulmonary TB described in association with cyclic neutropenia and chronic diarrhoea in Africa.