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CASE HISTORY in April 2001,Abdul,a Four-Month-Old Infant from Saudi Arabia,was Hospitalized with Hospitalized

Question 43

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CASE HISTORY
In April 2001,Abdul,a four-month-old infant from Saudi Arabia,was hospitalized with fever,tender neck,and purplish,nonblanching spots (petechiae and purpuric spots) on his trunk.Suspecting meningitis,the clinician took a CSF sample and examined it by Gram stain.The smear revealed Gram-negative diplococci inside PMNS.The CSF was turbid with 900 leukocytes/ml,and Neisseria meningitidis was confirmed by culture.The child was treated with cefotaxime and made a full recovery.His father,the person who brought him in,was clinically well.However,meningococcus was isolated from his oropharynx,as well as from the throat of the patient's two-year-old brother.Isolates from the patient,his father,and his brother were positive by agglutination with meningococcus a,c,y,W135 polyvalent reagent.The father's vaccination certificate confirmed that he had received a quadrivalent meningococcal vaccine.All three isolates were sent to the World Health Organization collaborating center,which confirmed meningococcus serogroup W135.DNA analysis of the three isolates found them to be indistinguishable,meaning that the father and his children were infected with the same strain of N.meningitidis.
Identify the INCORRECT statement regarding the pathogenesis and prevention of Abdul's meningitis.


A) N. meningitidis generally only infects infants, explaining why Abdul's father and brother showed no symptoms of disease.
B) Ten to twenty percent of the healthy population can be colonized by N. meningitidis and remain asymptomatic.
C) Complement deficiencies make individuals particularly susceptible to meningococcal meningitis.
D) N. meningitidis utilized type IV pili to disrupt tight junctions, allowing passage through the blood-brain barrier.

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