A 4-Week-Old Girl Is Brought to the Emergency Department Due

question 88

Multiple Choice

A 4-week-old girl is brought to the emergency department due to poor feeding and increasing lethargy.  The patient was born at term and had been well until 2 days ago, when she started sleeping throughout the day.  She has been difficult to arouse for feeds and has had little interest in eating when awake.  This morning, the patient had several episodes of emesis after the family attempted to feed her.  Temperature is 39.4 C (102.9 F) , and she is mildly tachypneic. A lumbar puncture is performed, and the patient is admitted due to concerns for infection.  CSF culture grows numerous gray colonies on blood agar, with a narrow area of clearing surrounding each colony.  Gram staining shows gram-positive cocci in short chains.  Which of the following virulence factors is primarily involved in the pathogenesis of this patient's infection?

• A)Antigenic variation of membranous proteins
• B)Catalyzation of hydrogen peroxide to oxygen and water
• C)Increased uptake of extracellular iron
• D)Lipopolysaccharide deposition in outer membranes
• E)Polysaccharide capsule formation around organism
• F)Rapid, flagella-mediated motion

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