usmlebuzz
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A 20-year-old marine in boot camp develops meningitis. The patient had developed pharyngitis before he developed the meningitis. Which of the following organisms is responsible for the cause?
A Group A beta hemolytic Streptococci
B Corynebacterium diphtheriae
C Bordetella pertussis
D Haemophilus influenzae
Neisseria meningitidis
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| Yulia
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Neisseria Meningitidis
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| veri
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The answer is A because first has pharyngitis.
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| Yulia
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Hi,
if the question was about the most common agent causing pharyngitis, you would be correct then. Group A beta hemolytic Strep doesn't cause meningitis, which this pt has.
on the other hand, meningococci have Ig A protease, which allows to colonize oropharynx and i don't see why pt couldn't have pharyngitis...
plus, the most common cause of meningitis in young adults is meningococci.
Veri, do you still disagree?
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| alice8
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Complications of Group A Beta-Hemolytic Streptococcal Pharyngitis
------------------------------------------------------------------------- -------
:arrow: Nonsuppurative complications
Rheumatic fever
Poststreptococcal glomerulonephritis
:arrow: Suppurative complications
Cervical lymphadenitis
Peritonsillar or retropharyngeal abscess
Sinusitis
Mastoiditis
Otitis media
Meningitis
Bacteremia
Endocarditis
Pneumonia
....................
Yulia you're particlarly right ,with this age group n.meningitis is the m.c.c of meningitis but i think the presentation of pharyngitis before meningitis makes the causative agent GABHS
and for the Ig A protease,pathogenic species of neisseria have this enzyme but only N. gonorrhoeae can cause Pharyngitis not N.meningitis as far as i know
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| alice8
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:arrow: Infections Associated with Neisseria meningitidis and Neisseria gonorrhoeae
N. meningitidis : Meningitis ,Septicemia ,Pneumonia ,Urethritis,Arthritis
N. gonorrhoeae : Urethritis ,Cervicitis ,Salpingitis ,Proctitis ,Septicemia ,Arthritis ,Conjunctivitis ,Pharyngitis ,Pelvic inflammatory disease
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| Yulia
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Alice8 i get your point,,,
and not going to argue about this one 
and still - young adult with meningitis in a military camp - i would pick n meningitis on the exam. this is my private opinion, that's what i would do.
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| alice8
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i respect :P although i would pick GABHS ,i still have dillema about the right answer...maybe ritu would like to give right one
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| Yulia
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In the mean time, guys, don't you think that those questions aren't quite good for step 2?
I did some exam master sample questions and they all seemed first-stepish... i wouldn't mind if the actual exam was like that, but afraid that's not the case.
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| veri
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so Ritu, what is the answer?
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why cannot it be H.inf
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| usmlebuzz
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looking at the excessive discussion on the topic between u guys I am scared of giving the answer now , :-#
but according to exam master it is N meningitidis, but dont question me why not the other one I was trying to solve my doubt , and now I am more confused :cry:
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| alice8
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:? 
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| Nubie
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I guess the problem is with the question stem and with its ideal world scenario.
If most common cause is asked, Pneumococcus would come before GABHS for Meningitis.
And given the scenario (for the exam only), Meningococcus would be likely before Strep.
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