A 15-month-old boy is brought to the emergency room with a fever and edema in his feet. Four days ago, the patient had edema in his right foot and a fever. Swelling of the left foot has also occurred today. A 9-month-old perianal abscess has a considerable medical history. Imaging examinations indicate osteomyelitis in both feet's metatarsal bones. Although intravenous antibiotics are given, the patient still has a fever and bilateral foot edema two weeks later. A laboratory examination reveals chronic neutrophilic leukocytosis. Staphylococcus aureus develops in bone biopsy cultures. The search for an underlying diagnosis begins; the patient's peripheral blood is stimulated with phorbol myristate acetate (PM A) and compared to a control using a rhodamine derivative. Which of the following processes is most likely impaired in this patient?

Question

A 15-month-old boy is brought to the emergency room with a fever and edema in his feet. Four days ago, the patient had edema in his right foot and a fever. Swelling of the left foot has also occurred today. A 9-month-old perianal abscess has a considerable medical history. Imaging examinations indicate osteomyelitis in both feet's metatarsal bones. Although intravenous antibiotics are given, the patient still has a fever and bilateral foot edema two weeks later. A laboratory examination reveals chronic neutrophilic leukocytosis. Staphylococcus aureus develops in bone biopsy cultures. The search for an underlying diagnosis begins; the patient's peripheral blood is stimulated with phorbol myristate acetate (PM A) and compared to a control using a rhodamine derivative.  Which of the following processes is most likely impaired in this patient?

Quizplus · Accepted Answer

Eductional Objective: Chronic granulomatous disease (CGD) is caused by a faulty NADPH oxidase and can be detected via dihydrorhodamine testing, which detects neutrophil respiratory burst. When NADPH oxidase is activated, dihydrorhodamine is ordinarily oxidized and fluoresces green (increased fluorescence intensity); however, in individuals with CGD, it stays colorless (ie, no oxidation).

A 15-Month-Old Boy Is Brought to the Emergency Room with a Fever