A 22-year-old woman comes to the physician because of urinary frequency, pelvic discomfort, and purulent urethral discharge following unprotected sex with a new partner. She has a history of chronic ear infections and asthma. Her only medication is a combined fluticasone-albuterol inhaler. She does not smoke cigarettes and drinks alcohol socially up to 4 times per week. Her temperature is 36.0°C (96.8°F), pulse is 70/min, and blood pressure is 125/80 mm Hg. Nucleic acid amplification testing is positive for Neisseria gonorrhoeae infection. The patient develops antibody against the bacterial pili that enhance attachment to host cells. Her symptoms resolve with adequate treatment. Several weeks later, the patient develops N gonorrhoeae reinfection after repeat exposure to the same partner. Which of the following is the most likely reason for the lack of long-lasting immunity against the bacteria despite antibody formation in this patient?

Question

A 22-year-old woman comes to the physician because of urinary frequency, pelvic discomfort, and purulent urethral discharge following unprotected sex with a new partner. She has a history of chronic ear infections and asthma. Her only medication is a combined fluticasone-albuterol inhaler. She does not smoke cigarettes and drinks alcohol socially up to 4 times per week. Her temperature is 36.0°C (96.8°F), pulse is 70/min, and blood pressure is 125/80 mm Hg. Nucleic acid amplification testing is positive for Neisseria gonorrhoeae infection.  The patient develops antibody against the bacterial pili that enhance attachment to host cells.  Her symptoms resolve with adequate treatment. Several weeks later, the patient develops N gonorrhoeae reinfection after repeat exposure to the same partner.  Which of the following is the most likely reason for the lack of long-lasting immunity against the bacteria despite antibody formation in this patient?

Quizplus · Accepted Answer

Eductional Objective: Gonococci use their pili to mediate adherence to the mucosal epithelium.  Through antigenic variation, each gonococcus can modify the pilus protein expressed, thereby avoiding host defenses (to some degree) and making vaccination directed against the pilus protein difficult.

A 22-Year-Old Woman Comes to the Physician Because of Urinary