A 3-Year-Old Boy Is Brought to the Office Due to a 1-Day

question 66

Multiple Choice

A 3-year-old boy is brought to the office due to a 1-day history of fever and irritability.  The mother states that the boy has been tugging at his right ear.  The patient has had 2 previous episodes of acute otitis media.  Temperature is 38.1 C (100.6 F) .  Otoscopic examination shows a perforated right tympanic membrane with erythema and purulent exudate.  Cultures from the exudate yield small, oxidase-positive, gram-negative coccobacilli that grow on factor X- and factor V-supplemented media, consistent with Haemophilus influenzae.  The patient's immunizations are up to date.  Which of the following best explains this patient's susceptibility to the pathogen causing his current infection?

• A)No vaccine is effective against H influenzae
• B)The patient has defective cell-mediated immunity
• C)The patient has defective neutrophil function
• D)The strain responsible for this patient's disease does not produce a capsule
• E)The strain responsible for this patient's disease produces exotoxin

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