A 26-Year-Old Man Is Brought to the Emergency Department Due

A 26-year-old man is brought to the emergency department due to fever and lethargy.  His girlfriend says the patient abruptly began experiencing fever, chills, vomiting, and diarrhea several hours ago, which were quickly followed by lightheadedness and lethargy.  He has no prior medical conditions other than an episode of epistaxis after a bar fight 3 days ago.  The patient does not smoke cigarettes or use injection drugs.  There is no history of exposure to sick contacts, and he has not eaten anything out of the ordinary.  Temperature is 38.9 C (102 F) , blood pressure is 90/60 mm Hg, and pulse is 120/min.  Physical examination shows a diffuse, erythematous rash.  There is an anterior nasal packing in the left nostril, removal of which shows mild mucosal erythema with a purulent discharge.  Cardiopulmonary and abdominal examinations reveal no abnormalities, and signs of meningeal irritation are absent.  Which of the following processes is most essential in pathogenesis of this patient's current condition?

A) Activation of toll-like receptors by bacterial components
B) Binding of T-cell receptors by bacterial secretory products
C) Bridging of cell-bound IgE by multivalent antigens
D) Phagocytosis of bacteria in the blood by neutrophils
E) Presentation of processed antigens by dendritic cells

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