ts.)A 22-year-old female schoolteacher was brought to the emergency room after a
ID: 187147 • Letter: T
Question
ts.)A 22-year-old female schoolteacher was brought to the emergency room after a 2-day history of headache and fever. On the day of admission, the patient had failed to come to school and could not be reached by telephone. When notified of this fact, the patient's mother went to her daughter's apartment, where she found her daughter in bed, confused and highly agitated. The patient was rushed to the local hospital, where she was comatose on arrival. Purpuric skin lesions were present on her trunk and arms. Analysis of her CSF revealed the presence of 380 cells/mm3 (93% polymorphonuclear leukocytes), a protein concentration of 220 mg/dl, and a glucose concentration of 32 mg/dl. Gram stain of CSF showed many gram-negative diplococci, and the same organisms were isolated from blood and CSF. The patient died despite prompt initiation of therapy with penicillin. What is the most likely organism responsible for this fulminant disease? What is the most likely source of this organism? 1. 2. What other diseases does this organism cause? 3. What virulence factors have been associated with other bacterial species in this genus?Explanation / Answer
1) organism- Neisseria meningitidis; its source - infected aerosols which she might have inhaled or kissed an infected partner.
2) meningitis, meningococcemia
3) it has a layer of lipopolysaccharides which acts as a potent endotoxin causing septic shock in patients. Other virulence factors are its polysaccharide capsule and fimbrae which in partnership with pilli help in its attachment during infection
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