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General Medicine General 128b755f

A previously healthy 18-month-old girl is brought to the office with 2 days of irritability, poor appetite, and pulling at her left ear. She has no known allergies, and her temperature is 102.8 F. She is easily consoled by the mother and moves her neck spontaneously without discomfo. There is a clear discharge from the nares. The left tympanic membrane is erythematous, dull, and bulging. Which of the following virulence factors is generally absent in the strains of the causative organism that produce otitis media, compared with those that produce epiglottitis or meningitis?

A
Beta-Lactamase
B
IgA protease
C
Lipopolysaccharide
D
Polyribitol phosphate

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