A 34-Year-Old Man Comes to the Emergency Department Due to 2

question 104

Multiple Choice

A 34-year-old man comes to the emergency department due to 2 days of fever, malaise, and myalgia.  He has also had worsening shortness of breath and cough.  The patient works in the mail room at a large company, does not smoke cigarettes, and drinks alcohol occasionally.  Chest imaging shows lung infiltrates and prominent widening of the mediastinum.  Sputum and blood cultures yield large, gram-positive rods that form colonies resembling a "Medusa head."  Which of the following is the most likely bacterial virulence factor contributing to this patient's condition?

• A)Antiphagocytic D-glutamate capsule
• B)Antiphagocytic polysaccharide capsule
• C)IgG-binding, outer membrane protein
• D)Intracellular polyphosphate granules
• E)Peritrichous flagella

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