You Are an RN Working in the Emergency Department (ED)

You are an RN working in the emergency department (ED) at a major hospital in New York City. During one shift, you see two patients who are exhibiting coughing with blood-containing sputum, and shortness of breath. Both patients report that they have experienced headaches, muscle aches, high fever, confusion, and shaking chills in the days preceding their ED visit. One of the patients also has some digestive tract symptoms including diarrhea, abdominal pain, and vomiting. You discover that the patients live in the same apartment building, although they do not know each other. You suspect that they have a type of pneumonia, and given the circumstances, think it may be legionellosis. You read up on this disease to refresh your memory about it.
-L. pneumophila is a facultative intracellular parasite. How does it manipulate the immune system so as to enter host cells?

A) The bacterial cells bind complement component C3b (an opsonin) , enhancing phagocytosis.
B) The bacteria have macrophage invasion potentiator (Mip) that promotes their uptake by alveolar macrophages. 
C) The bacteria cause necrosis of alveolar cells, leading to an inflammatory response.
D) The bacteria survive in alveolar macrophages by preventing phagosome-lysosome fusion AND the bacteria cause necrosis of alveolar cells, leading to an inflammatory response.
E) The bacterial cells bind complement component C3b (an opsonin) , enhancing phagocytosis AND the bacteria have a surface protein (Mip) that promotes their uptake by alveolar macrophages.