A 6-year-old boy is brought to the physician by his parents because of a 3-day history of fever, headache, and cough productive of a green, foulsmelling discharge that also exits from his nose. He has had repeated episodes of similar symptoms during the past 4 years. He appears pale and lethargic. His height and weight are both below the 10th percentile. Coarse rhonchi are heard bilaterally. An x-ray of the chest shows scattered peripheral opacities, dilated and thickened airways consistent with bronchiectasis, and a cardiac apex that is directed toward the right. The most likely cause of his recurrent infections is a dysfunction of which of the following cell types?
(A) Alveolar capillary endothelial cell
(B) Alveolar macrophage
(D) Ciliated columnar epithelial cell
(E) Clara cell
(F) Goblet cell
(G) Kulchitsky cell
(H) Squamous epithelial cell
(I) Type I pneumocyte
(J) Type II pneumocyte
Correct answer : (D) Ciliated columnar epithelial cell
This is a case of Kartagener’s syndrome – a triad of sinusitis, bronchiectasis and situs inversus. Here there is dysfunction of ciliated columnar epithelium.