A 40-Year-Old Woman Is Evaluated for Neck Pain That Has

A 40-year-old woman is evaluated for neck pain that has gradually worsened over the past several months.  The patient reports a pulling sensation in her neck that causes difficulty in keeping her head straight.  She has had no trauma and has no other medical conditions.  Physical examination shows a spastic and thickened sternocleidomastoid muscle causing head tilt.  The patient is diagnosed with idiopathic torticollis.  She is treated with injections of a bacterial product into the affected muscle, with significant relief of her symptoms.  The substance administered to this patient is derived from bacteria that most likely demonstrate which of the following characteristics?

A) Antigenically hypervariable pili
B) Antiphagocytic capsule
C) IgG-binding outer membrane protein
D) Intracellular polyphosphate granules
E) Subterminal spore formation
F) Type III secretion system

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