A case of panhypogammaglobulinemia masquerading as child abuse

A case of panhypogammaglobulinemia in a 15-month old boy is presented. The child was followed at a local university teaching hospital for pneumonia, failure to thrive, and possible child abuse/neglect. Following minor trauma to the face, massive sepsis developed in the child. The mother was afraid to seek medical care because she was fearful of legal action against her. Upon the child's demise at home, police and medical examiner involvement ensued. The correct diagnosis was established at autopsy.