[khanar]

A 23 year old female came to the physician because of three days history of fever, nausea, and vomiting. Plus 4 days history of urgency and dysuria. PE showed suprapubic and flank tenderness. Urine exam showed 30WBC/hpf. Which of the following best describe the virulence factor of the most likely causal organism?

A- P pilli
B- M protein
C- Protein F
D- Lipoteichoic acid
E- Pyrogenic exotoxin

 

[Seetal]

is it D

is it D-lipotechoic acid of gram - cell wall? this is E.coli ryte?

 

[khanar]

I don't think so

is it D-lipotechoic acid of gram - cell wall? this is E.coli ryte?

Teichoic acid is seen in Gram positive not Gram negative organisms

 

[Seetal]

oops

Teichoic acid is seen in Gram positive not Gram negative organisms

oh damn... u're absolutely right. what was i thinking. so then P pili?

 

[khanar]

It's a staph

oh damn... u're absolutely right. what was i thinking. so then P pili?

I think the answer is M protein.
this girl is young and staph saprophyticus is likely here

 

[HouseWannabe]

I think it's Neisseria, causes Urthritus, and PID which would explain the flank pain and dysuria. It's a gram-ve so can't be B/D/E that leaves A or C, and to be honest I can't remember if there is even a protein F so i pick A

 

[khanar]

It's A for sure

Yes, that's an easy question.
The girl is having E.coli pyelonephritis and the virulence factor is definitely P pili there's no doubt about this.

 

[achistikbenny]

i think the patient has pyelonephritis-associated pili. she has ascending infection to the renal pelvis due to E COLI infection ,ie vesicoureteral reflux of urine .the suprapubic pain is due to cystitis and the flank pain,fever wbc cast etc...is due to pyelonephritis.so the virulence factor for e coli adherence to the uroepithelium is the p-pili.

 

[Seetal]

hmm.. no definite answer posted on this one. so then for sure we settling on P pili of E.coli?