صورة وتعليق........الحلقه 40 A 2-yr-old boy presents in late summer with fever, lethargy, and a stiff neck. CBC shows a hemoglobin of 13.2 g/dL, platelet count of 323,000/mm3, and white blood cell count of 14,200/mm3 with a differential of 32% granulocytes, 3% bands, 56% lymphocytes, and 9% mononuclear cells. A lumbar puncture CSF specimen contains 230 leukocytes/mm3 with 80% lymphocytes and 20% granulocytes. The CSF glucose is 60 mg/dL (blood glucose is 100 mg/dL), and CSF protein is 55 mg/dL. Gram stain shows moderate white blood cells and no organisms. After 4 days the boys clinical status remains unchanged. Results of bacterial cultures of the blood, urine, and CSF are negative, and a polymerase chain reaction assay of the CSF for herpes simplex virus is negative. The patients past medical history reveals that he has had many ear infections and required bilateral myringotomy tubes at age 13 mo. He was hospitalized once for pneumonia but responded well to antibiotics.Which of the following immunologic laboratory abnormalities would be most consistent with this childs history? 1-Very low to undetectable IgG levels 2-Abnormal result on NBT test 3-Abnormal neutrophil killing of S. aureus 4-Very low to undetectable levels of CD4 cells 5-Elevated levels of IgE.
Posted on: Sat, 12 Jul 2014 16:04:09 +0000