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Cleave immunoglobulin
9%
16/183
Inhibit leukocyte migration
17/183
Inhibit phagocytosis
44%
81/183
Inhibit ribosomal function
16%
30/183
Trigger widespread inflammation
29/183
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The patient in this vignette presents with fever and severe lymphadenopathy after significant exposure to rodents suggestive of bubonic plague. Yersinia pestis causes bubonic plague and produces the anti-phagocytic F1 capsular antigen. Yersinia pestis is a coagulase-positive, gram-negative rod that is transmitted from rodents to fleas to humans. It causes bubonic plague which is characterized by hot lymphadenopathy and skin hemorrhages with black discoloration (thus the name, black death). Yersinia pestis is a highly virulent pathogen that relies on the F1 capsular antigen to prevent phagocytosis by host macrophages. Small outbreaks of the plague regularly occur in Southeast Asia and sub-Saharan Africa. Incorrect Answers: Answer 1: Streptococcus pneumoniae produces an IgA protease that cleaves host immunoglobulin. Answer 2: Cord factor is a virulence factor produced by mycobacterium tuberculosis that inhibits leukocyte migration. Answer 4: Several virulence factors inhibit ribosomal function including the AB exotoxin (C. diphtheriae), heat-labile toxin (E. coli), exotoxin A (P. aeruginosa), and pertussis toxin (B. pertussis), among others. Answer 5: Endotoxin is a component of gram-negative bacterial cell walls that trigger widespread inflammation by binding to monocytes and inducing degranulation. Bullet Summary: Yersinia pestis produces the F1 capsular antigen which prevents phagocytosis by host macrophages.
3.1
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