Bacteriology USMLE Step 1 Practice Question
A 28-year-old G2P1 woman at 20 weeks gestation presents to the emergency department with a 2-day history of fever (38.5°C), myalgias, and mild nausea. She reports recent consumption of unpasteurized soft cheese at a restaurant. Vital signs are notable for blood pressure 118/76 mmHg, heart rate 92/min, respiratory rate 16/min, and oxygen saturation 98% on room air. Physical examination is unremarkable with no nuchal rigidity. Blood cultures grow a gram-positive rod that is catalase-positive and demonstrates tumbling motility at room temperature (25°C). Cerebrospinal fluid culture is negative. The patient has not yet been started on antibiotics. Which of the following is the most likely serious fetal/neonatal consequence if maternal infection is not treated promptly?
Answer choices
- ANeonatal tetanus and maternal lockjaw
- BAmnionitis progressing to fetal loss and neonatal meningitis if delivery occursCorrect answer
- CCongenital cataracts and cardiac defects from vertical transmission
- DMaternal toxic shock syndrome with fetal demise from hypotension
- ENeonatal conjunctivitis and pneumonia only without CNS involvement
- FPreeclampsia with placental insufficiency and intrauterine growth restriction
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