Hyperimmunoglobulin E syndrome is also know as Job syndrome, after the biblical character Job whose faithfulness was tested by a lifelong affliction of draining skin sores and pustules. People afflicted have chronic severe skin infections and abscess formation. The sinuses and airways (including lungs) are also frequently infected. Other sites of infection include bone and visceral abscesses. The most commonly involved bacteria is Staphylococcus aureus. Other common organisms are Streptococcus pneumoniae (bacterium), Hemophilus influenzae (bacterium), Candida albicans (yeast), and the herpes virus (virus).

Hyper IgE syndrome is in most cases inherited in a dominant fashion, meaning that it can run in families with high frequency.

• persistent skin abscesses and infection
• recurrent purulent sinusitis
• subcutaneous abscesses
• eczema
• chronic runny nose (allergic rhinitis)
• asthma
• recurrent skin infections
• increased pulmonary infections

• keratoconjunctivitis
• osteomyelitis
• kyphoscoliosis
• lung abscesses on chest X-ray
• recurrent sinus infection

• Quantitative immunoglobulins reveal high serum IgE levels
• marked eosinophilia by CBC with differential
• defective neutrophil and monocyte chemotactic studies (though not in all cases)
• absent delayed hypersensitivity (DCNB, candidal)

• X-ray of the sinuses
• X-ray of the bone(s)
• X-ray and CT scan of the chest
• cultures of infected site

There is no known cure for the condition. The goal of treatment is control of the recurrent infections. Medications include antibiotic treatment of infections with whatever antibiotic is specific for the organism causing the infection. Antifungal agents are prescribed when appropriate. Antiviral agents are given when appropriate.

Sometimes surgical drainage of abscesses is needed.

IV gamma globulin may help to build up the immune system temporarily when there are severe infections.

• repeated infections
• infection spread throughout the body (see sepsis)