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A 34-Year-Old Man Is Admitted to the Intensive Care Unit

Question 332

Multiple Choice

A 34-year-old man is admitted to the intensive care unit due to fever, chills, shortness of breath, and altered mental status.  His symptoms began 3 days ago and have progressively worsened over the last 24 hours.  His past medical history is significant for a motor vehicle accident 2 years ago in which he sustained blunt abdominal trauma and required emergency laparotomy due to internal bleeding.  His blood pressure is 81/44 mm Hg and pulse is 122/min.  He is started on broad-spectrum antibiotics, intravenous fluids, and vasopressors.  His condition continues to deteriorate and he dies in the hospital several hours later despite extensive resuscitation efforts.  Blood cultures obtained on admission grow Streptococcus pneumoniae.  Impairment of which of the following mechanisms most likely contributed to the severity of this patient's infection?


A) Complement production
B) Immediate hypersensitivity
C) Intracellular killing
D) Systemic bacterial clearance
E) Type I interferon release

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