A 37-year-old woman, Maimuz, presents with 3 days of progressive joint pain in her ankles, knees, and wrists. She recalls three similar episodes over the past several years. On examination, she has a temperature of 38.7 C, her blood pressure is 110/70 mm Hg, and her hea rate is 90/min. She has a diffuse petechial rash over her trunk and extensor surfaces. Her ankles and knees are swollen, red, and tender with decreased range of motion, and there is tenderness over the tendon sheaths of her hands and forearms. Blood cultures are negative. Aspiration of joint fluid reveals a white cell count of 22,000/mm3 with no visible organisms, but culture on chocolate agar is positive. Which of the following is an attribute of the causative organism that allows it to produce recurrent infections?
This is a case of Neisseria gonorrhoeae ahritis. Patients are continuously susceptible to reinfection because of antigenic variation and phase variation of the pili. N. gonorrhoeae is not an intracellular pathogen, although it may be found intracellularly in neutrophils after it has been phagocytized. Ceftriaxone is the drug of choice for N. gonorrhoeae. Gonococci are especially susceptible to complement-mediated lysis, not resistant to it.
It is an intracellular pathogen
It is resistant to ceftriaxone
It is resistant to complement-mediated lysis
Its pili undergo antigenic and phase variation