Good syndrome, a rare disease that physicians cannot afford to overlook; case report and review of literature.

Introduction Good syndrome (thymoma with immunodeficiency) is a rare cause of immunodeficiency.1There is a combined B and T cell immunodeficiency with hypogammaglobulinemia, reversal of the CD4/CD8 ratio and reduced or absent B cells causing an increased susceptibility to bacterial, viral and fungal infections. It is classified as a primary immunodeficiency,2 and patients usually present with recurrent infections or a mediastinal mass.3The infrequency with which it is encountered makes Good syndrome a diagnostic challenge.