A 3-year-old boy is brought to the physician for the evaluation of recurrent skin lesions. The lesions first appeared at the age of 2 months and multiple treatment options have been attempted without success. He has also had several episodes of respiratory tract infections, enlarged lymph nodes, and recurrent fevers since birth. The patient's immunizations are up-to-date. He is at the 5th percentile for length and 10th percentile for weight. He appears ill. His temperature is 38°C (100.4°F), pulse is 100/min, and blood pressure is 100/60 mm Hg. Examination shows several raised, erythematous lesions of different sizes over the face, neck, groin, and extremities; some secrete pus. Cervical and axillary lymph nodes are enlarged bilaterally. This patient most likely has an increased risk of infection with which of the following organisms?

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Eductional Objective: Chronic granulomatous disease (CGD) results from defective NADPH oxidase.  Normally, this enzyme participates in the respiratory burst pathway to produce reactive oxygen species critical in intracellular pathogen killing.  Patients with CGD develop recurrent bacterial and fungal infections predominantly caused by 5 catalase-positive organisms: Staphylococcus aureus, Burkholderia cepacia, Serratia marcescens, Nocardia, and Aspergillus.

A 3-Year-Old Boy Is Brought to the Physician for the Evaluation