20个月男孩，反复呼吸道感染6个月余，1周前出现发热，咳嗽加重。曾因肺炎3次住院治疗。体检：精神萎靡，呼吸促，未见扁桃体，浅表淋巴结未扪及。双肺可闻及细湿啰音。心脏无异常。腹部无异常。胸片示双肺炎症，未见胸腺。实验室检查：WBC14x109/L,N0.72,L0.28,NBT阳性细胞95%;血清总Ig180mg/L,IgA40mg/L,IgM90mg/L。该患儿最可能的诊断是

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