Question

A 42-year-old man comes to the office due to 2 weeks of progressive fever, chills, abdominal discomfort, and loose stools, which began during a trip to Southeast Asia. He received no pre-travel vaccinations and did not strictly follow food and water safety precautions during the trip. The patient has no chronic medical conditions but has experienced a prior episode of Salmonella enteritidis gastroenteritis, which resolved with symptomatic care. Temperature is 39.4 C (103 F), blood pressure is 110/64 mm Hg, pulse is 62/min, and respirations are 18/min. Physical examination reveals a faint macular rash on the trunk. There is mild tenderness on palpation of lower abdominal quadrants with no guarding or rebound tenderness. Blood culture grows non-lactose fermenting gram-negative rods. Which of the following best explains the prolonged and severe disease course from this pathogen compared to the patient's previous bacterial infection? Villus epithelial cell destruction Contact-dependent host cytotoxicity Extensive intra-phagocytic multiplication Potent exotoxin production Cross-reacting antibody formation

          A 42-year-old man comes to the office due to 2 weeks of progressive fever, chills, abdominal discomfort, and loose stools, which began during a trip to Southeast Asia. He received no pre-travel vaccinations and did not strictly follow food and water safety precautions during the trip. The patient has no chronic medical conditions but has experienced a prior episode of Salmonella enteritidis gastroenteritis, which resolved with symptomatic care. Temperature is 39.4 C (103 F), blood pressure is 110/64 mm Hg, pulse is 62/min, and respirations are 18/min. Physical examination reveals a faint macular rash on the trunk. There is mild tenderness on palpation of lower abdominal quadrants with no guarding or rebound tenderness. Blood culture grows non-lactose fermenting gram-negative rods. Which of the following best explains the prolonged and severe disease course from this pathogen compared to the patient's previous bacterial infection?
Villus epithelial cell destruction
Contact-dependent host cytotoxicity
Extensive intra-phagocytic multiplication
Potent exotoxin production
Cross-reacting antibody formation

A 42-year-old man comes to the office due to 2 weeks of progressive fever, chills, abdominal discomfort, and loose stools, which began during a trip to Southeast Asia. He received no pre-travel vaccinations and did not strictly follow food and water safety precautions during the trip. The patient has no chronic medical conditions but has experienced a prior episode of Salmonella enteritidis gastroenteritis, which resolved with symptomatic care. Temperature is 39.4 C (103 F), blood pressure is 110/64 mm Hg, pulse is 62/min, and respirations are 18/min. Physical examination reveals a faint macular rash on the trunk. There is mild tenderness on palpation of lower abdominal quadrants with no guarding or rebound tenderness. Blood culture grows non-lactose fermenting gram-negative rods. Which of the following best explains the prolonged and severe disease course from this pathogen compared to the patient's previous bacterial infection?
Villus epithelial cell destruction
Contact-dependent host cytotoxicity
Extensive intra-phagocytic multiplication
Potent exotoxin production
Cross-reacting antibody formation

Added by Jessica R.

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