Question

A set of worried parents show up at your office practice in southern Ohio with their two-year-old son. It seems that their son has been getting sicker and sicker with cough and high fevers ever since all three had attended the Pork and Peanut Festival about ten days ago. The child is coughing up purulent and malodorous gobs of phlegm, he has a low-grade fever, and auscultation of the lungs reveals adventitious crackles over the right middle lobe area. The family returns two hours later with the son's chest x-ray in hand. It shows an opacity corresponding to the right middle lobe. Since the child has no molars, you suspect that he aspirated either a peanut or a piece of pork at the Festival. If that were the case, you would expect the secondary lymphoid organ area with the highest bacterial load to be?

The lymph nodes draining the right middle lobe of the lung
The tonsils
The spleen
The bone marrow
The thymus

Answer 1

The lymph nodes draining the right middle lobe of the lung would have the highest bacterial load in the young boy with suspected aspiration pneumonia, due to localized immune response to aspirated material. Option C.

Step-by-step explanation:

In the case of the two-year-old boy with suspected aspiration pneumonia after attending the Pork and Peanut Festival, the secondary lymphoid organ area with the highest bacterial load would likely be the lymph nodes draining the right middle lobe of the lung.

This is because foreign matter, like a peanut or piece of pork that was possibly aspirated, would initiate a localized immune response, causing inflammation and bacterial infection in the lung.

The lymph nodes associated with the affected lung lobe are responsible for filtering lymphatic fluid and would consequently harbor an increased load of pathogens due to this local infection.

The tonsils, spleen, bone marrow, and thymus each play significant roles in immune function, but would not directly filter bacteria from an isolated aspiration event in the lung.

Specifically, it's the bronchus-associated lymphoid tissue (also known as BALT) that would be actively involved in trapping and presenting antigens to immune cells in this context. Option C.