Health condition
Chronic granulomatous disease adults
Chronic granulomatous disease (CGD) is an inherited defect of the neutrophil respiratory burst - phagocytes swallow microbes but cannot kill them - causing abscesses, unusual infections and inflammatory granulomas; with modern prophylaxis, most patients now live well into adulthood.
Why trust this guide
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Editorial team
Written by our editorial team from the UK sources listed on each page.
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Sourced from guidance
Checked against current NHS and UK specialist society guidance at the time of review.
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Current for 2026
Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.
Key facts
The essentials at a glance.
The symptoms to recognise, when to seek help, which specialist to see, and what treatment usually involves.
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The organisms tell the story: recurrent infections with staphylococcus, serratia, burkholderia, nocardia and aspergillus - especially abscesses of skin, lymph nodes, liver and lung
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Diagnosis: a neutrophil function test (DHR flow cytometry) rather than antibody levels - immunoglobulins are normal
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Inflammation is half the disease: granulomas can obstruct the gut or bladder, and a Crohn's-like colitis is common
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Lifelong prophylaxis - co-trimoxazole plus itraconazole - transformed survival; interferon-gamma is added in some centres
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Curative options (stem cell transplant, and gene therapy in trials) are increasingly considered even in adults; aspergillus exposure (mulch, compost, building dust) warrants specific avoidance advice
Understanding the condition
What it is and what happens next.
What causes it, how it is diagnosed, and the treatment routes available in the UK.
What it is and how it feels
Neutrophils normally finish their work with a burst of reactive oxygen - the chemical kill inside the phagosome. In CGD that burst never fires, so a specific rogues' gallery of catalase-positive organisms survives ingestion and sets up abscesses that recur and granulomas that obstruct. X-linked disease presents earliest; milder autosomal forms can smoulder into adult diagnosis after years of odd abscesses, liver lesions or fungal pneumonias. The inflammatory face - colitis mistaken for Crohn's disease, granulomas in the urinary tract - confuses the picture further, particularly since some immunosuppressants used for Crohn's are hazardous here.
Diagnosis and treatment routes
The DHR test is quick and definitive, genetics assigns the subtype and carrier information, and management then runs on two tracks: relentless prophylaxis (antibacterial, antifungal, exposure advice) with aggressive, source-seeking treatment of any fever; and measured control of inflammation with steroids or carefully chosen agents. Transplant discussions belong in specialist centres and have improving adult outcomes. Adults with a history of recurrent abscesses or aspergillus infection deserve neutrophil function testing; a private immunology appointment is typically available within about two weeks.
Seeing a specialist
Who to see, and how quickly you can be seen.
The specialist for this condition is usually a consultant clinical immunologist. Your GP can refer you on the NHS, or you can arrange a private consultation directly.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any of the emergency symptoms described above.
Frequently asked
Common questions about Chronic granulomatous disease adults.
Quick, plain-English answers to what people ask us most.
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What is chronic granulomatous disease?
Chronic granulomatous disease (CGD) is a rare inherited immune deficiency in which certain white blood cells cannot effectively kill some types of bacteria and fungi, leading to recurrent, sometimes severe infections and the formation of clusters of inflammatory tissue called granulomas. It is usually diagnosed in childhood, but this covers how it can present and be managed when it continues into or is first identified in adulthood. Milder forms may not be recognised until later in life.
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What causes chronic granulomatous disease?
It is caused by inherited mutations affecting an enzyme system that white blood cells (specifically neutrophils) need to produce chemicals that kill certain bacteria and fungi. Most cases are inherited in an X-linked pattern, primarily affecting males, though autosomal recessive forms also occur, affecting both sexes. Genetic testing can identify the specific mutation involved, which can help predict severity and guide management.
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What are the symptoms in adults?
Adults with CGD can experience recurrent bacterial and fungal infections, particularly affecting the lungs, skin, lymph nodes and liver, along with granuloma formation that can sometimes cause blockages, particularly in the digestive or urinary tract. Some adults have milder disease that was not diagnosed until later in life following a pattern of unusual or recurrent infections. The specific pattern and severity of symptoms vary between individuals.
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Is chronic granulomatous disease dangerous?
Yes, it can lead to serious, sometimes life-threatening infections, particularly with certain fungi and bacteria that the immune system cannot effectively fight without functioning treatment. With appropriate long-term preventive treatment and prompt management of any infections, however, many people with CGD lead active lives well into adulthood. Regular specialist immunology follow-up is important to manage ongoing risk.
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How is chronic granulomatous disease treated?
Treatment typically includes long-term prophylactic (preventive) antibiotics and antifungal medications to reduce the risk of infection, alongside prompt and often more intensive treatment of any infections that do occur. In some cases, stem cell transplantation can potentially cure the underlying immune defect, and gene therapy is an emerging area of research. Regular specialist immunology input guides ongoing management and monitors for complications.
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When should I see a specialist?
If you have a history of recurrent or unusual infections, particularly with certain fungi or bacteria, or a known family history of CGD, specialist immunology assessment is important. NHS immunology referral can take several weeks to months; a private consultation is typically available within about 2 weeks for earlier specialist assessment.