1-12 Two-year-old Janice Tumminello survived an episode of Haemophilus influenzae septicemia at 4 months by...

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1-12 Two-year-old Janice Tumminello survived an episode of Haemophilus influenzae septicemia at 4 months by intravenous antibiotic therapy. Her immunizations are up to date. Three days ago her adoptive parents became concerned when she became lethargic, had several bouts of vomiting, and developed a fever, and they took her to the emergency room. She had a rapid pulse and low blood pressure, her peripheral areas were cold, and pur- pura began to develop on her fingers and toes. Blood cultures tested positive for Streptococcus pneumoniae. Aggressive antibi- otic treatment and fluid-replacement therapy were successful in preventing further dissemination of the bacteremia. However, amputation of three digits on the left hand and debridement of her toes on both feet was required. A diagnosis of overwhelming severe pneumococcal sepsis was made. DNA analysis showed that Janice had a deleterious mutation in a gene encoding. which is associated with congenital asplenia. a. an immunoglobulin b. a defensinc. a ribosomal protein d. a complement protein e. a T-cell receptor.

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