CASE HISTORY Constance,a Seven-Month-Old Female,suffered from Recurrent Infections Since the Age of Age

Essay

CASE HISTORY
Constance,a seven-month-old female,suffered from recurrent infections since the age of two weeks.She was frequently admitted to the hospital for Staphylococcus aureus sepsis (blood infection),hepatosplenomegaly (enlarged liver and spleen),oral thrush caused by Candida albicans,and poor weight gain.Repeated treatments with different antibiotics only temporarily resolved her infections.Two days ago,her alarmed mother and father once again brought Constance to the emergency department at the University of Chicago Medical Center.Constance was lethargic,did not move much,and had a high fever.She also struggled for breath.Her blood work revealed high white blood cell counts (59,000/mm3;normal is 4,000-11,000)with a higher than normal level of neutrophils in her blood (neutrophilia).A chest X-ray showed inflammation in both lungs.It was no surprise,then,when the lab technician reported finding Staphylococcus aureus in Constance's blood.Her doctor ordered intravenous antibiotic therapy and was determined to find the cause of these repeated infections.He suspected a serious defect in Constance's immune system.Laboratory analyses found that her lymphocyte numbers,overall serum immunoglobulin (antibody)levels,and liver and kidney functions were all normal.No help there.Then flow cytometry analysis of surface proteins present on Constance's peripheral blood neutrophils revealed a complete absence of critically important membrane proteins.The doctor's heart sank.It was not good news.
Constance's neutrophils are unable to adhere to the walls of her blood vessels.In the normal process of inflammation,however,describe the next steps for these neutrophils.