Background: Common variable immunodeficiency is a heterogeneous syndrome characterized by
hypogammaglobulinemia and recurrent bacterial infections both in the upper and lower
respiratory tract. Patients with this disease are usually under-diagnosed and this diagnostic
delay contributes to morbidity and early mortality.
Case Report: We present a case of a 69-year-old-male with repeated pulmonary infections for the last six
years and diarrhea for the last three months. The patient was diagnosed to have bronchiectasis
and giardia lamblia infection due to Common variable immunodeficiency.The patient responded rapidly to antibiotic therapy and received since then, intravenous gamma globulin. He was also referred to a respiratory physician.
Conclusions: This case highlights that physicians must be vigilant for hypogammaglobulinemia in all patients with unexplained recurrent respiratory infections. Early initiation of monthly intravenous gamma globulin replacement therapy and involment of a respiratory expertise to initiate optimal therapy
reduces the incidence of infections and improves prognosis.

Keywords: Bronchiectacis, hypogammaglobulinemia, Giardia lamblia, Common Variable Immunodeficiency