A 30-Year-Old Primigravid Woman at 35 Weeks Gestation Comes to the Emergency

A 30-year-old primigravid woman at 35 weeks gestation comes to the emergency department due to fever, nausea, vomiting, watery diarrhea, and myalgias that began one day ago.  She has no contractions, vaginal bleeding, or leakage of fluid.  Temperature is 39.3 C (102.7 F) , blood pressure is 90/60 mm Hg, and pulse is 126/min.  The abdomen is soft, and the uterus is nontender.  Fetal heart rate is 180/min on Doppler ultrasound.  The remainder of the physical examination is normal.  Blood cultures grow gram-positive rods.  Which of the following is the major virulence factor of the organism responsible for this patient's clinical presentation?

A) Cytotoxin that creates pores in phagosomes
B) Endotoxin-mediated complement and tissue factor activation
C) Exotoxin inhibition of neurotransmitter release
D) Exotoxin-mediated inhibition of elongation factor

Correct Answer:

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