Review Question - QID 214752

A 45-year-old man is brought to the emergency department for shortness of breath and fever. The patient reports having flu-like symptoms including chills, fatigue, fever, and cough about a week ago. However, the patient reports worsening dyspnea with some hemoptysis over the past 2 days. He denies any recent sick contacts and no one living with him has similar symptoms. He works at a wool mill and denies any tobacco or alcohol use. On physical examination, the patient appears to be in respiratory distress with accessory muscle usage. The patient's temperature is 101.6°F (38.6°C), blood pressure is 90/50 mmHg, pulse is 110/min, respirations are 31/min, and pulse oximetry is 87%. The patient is subsequently started on intravenous fluids and supplemental oxygen. A chest radiograph is obtained, and its results are shown in Figure A. At the emergency department, the patient continues to decompensate and is intubated. Five days later, the patient dies in the intensive care unit. What is the mechanism of a toxin produced by the likely organism in the patient’s disease?