Which pathogen invades mucosa leading to marked neutrophilic inflammation and carrier state?

Which pathogen invades mucosa leading to marked neutrophilic inflammation and carrier state?

• A. Escherichia coli
• B. Campylobacter jejuni
• C. Salmonella species
• D. Helicobacter pylori

Answer: (C)

The pattern tested is invasive gut pathogens that penetrate the mucosa and provoke a strong neutrophilic inflammatory response, with a potential for a carrier state after infection. Salmonella species are classic for this: they invade the intestinal mucosa by crossing M cells in Peyer’s patches, triggering a brisk neutrophil-rich inflammatory reaction that leads to inflammatory diarrhea. Importantly, Salmonella Typhi and related serotypes can persist in the gallbladder and biliary tract, allowing ongoing shedding and a chronic carrier state even after symptoms resolve. Other options don’t fit this combination as neatly. Some bacteria can invade mucosa and cause neutrophilic inflammation, but a well-recognized long-term carrier state is most characteristic of Salmonella, particularly the typhoidal types. Helicobacter pylori is a gastric mucosal inhabitant causing chronic gastritis with neutrophils, but it’s not an intestinal mucosal invasive enteric pathogen with a systemic carrier state. E. coli and Campylobacter can cause inflammatory diarrhea, but they are not classically defined by a persistent carrier state in the same way Salmonella Typhi is.

The pattern tested is invasive gut pathogens that penetrate the mucosa and provoke a strong neutrophilic inflammatory response, with a potential for a carrier state after infection. Salmonella species are classic for this: they invade the intestinal mucosa by crossing M cells in Peyer’s patches, triggering a brisk neutrophil-rich inflammatory reaction that leads to inflammatory diarrhea. Importantly, Salmonella Typhi and related serotypes can persist in the gallbladder and biliary tract, allowing ongoing shedding and a chronic carrier state even after symptoms resolve.

Other options don’t fit this combination as neatly. Some bacteria can invade mucosa and cause neutrophilic inflammation, but a well-recognized long-term carrier state is most characteristic of Salmonella, particularly the typhoidal types. Helicobacter pylori is a gastric mucosal inhabitant causing chronic gastritis with neutrophils, but it’s not an intestinal mucosal invasive enteric pathogen with a systemic carrier state. E. coli and Campylobacter can cause inflammatory diarrhea, but they are not classically defined by a persistent carrier state in the same way Salmonella Typhi is.