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USMLE · Question #517

A 5-year-old boy is admitted to the hospital because of a 1-week history of fever and increasingly severe abdominal discomfort. At the age of 7 months, he was treated for osteomyelitis caused by…

The correct answer is E. Inability of leukocytes to kill intracellular microorganisms. See the full explanation below for the reasoning.

Question

A 5-year-old boy is admitted to the hospital because of a 1-week history of fever and increasingly severe abdominal discomfort. At the age of 7 months, he was treated for osteomyelitis caused by Aspergillus fumigatus. He has been admitted to the hospital three times during the past 4 years for severe pneumonia. He appears moderately ill. His temperature is 39°C (102.2°F). Abdominal examination shows an enlarged, tender liver. Ultrasonography of the abdomen shows an intrahepatic abscess. Culture of the abscess fluid grows Staphylococcus aureus. Further analysis shows failure of the neutrophils to undergo an oxidative burst when exposed to S. aureus. This patient has an increased susceptibility to infection as a result of which of the following abnormalities?

Options

  • ADeficient leukocyte production
  • BFailure of leukocytes to migrate between endothelial cells
  • CFailure of leukocytes to roll along the endothelial surface
  • DInability of leukocytes to ingest microorganisms
  • EInability of leukocytes to kill intracellular microorganisms

How the community answered

(24 responses)
  • A
    4% (1)
  • C
    4% (1)
  • D
    13% (3)
  • E
    79% (19)

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