Case 149

1.  Presented by Julia Gales, M.D. and reviewed by Sean Zhang, M.D., Ph.D.

A 60 patent with history of glioblastoma status post resection, chemotherapy, and radiation therapy, long term steroid use for seizures associated with his brain cancer, presents with a large fluid collection, concerning for an abscess. A culture of the collection is obtained, and the following organism grew from the culture:

Micrograph of a similar patient:
Photo credit: https://phil.cdc.gov/details.aspx?pid=3771
Photo credit: https://phil.cdc.gov/details.aspx?pid=3771


On further workup of the patient, numerous lesions were identified, concerning for an infectious origin.

 Question:  Which of the following is a major virulence factor for this organism?