Meningococcal endotoxin shock — MRCPCH TAS MCQ

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HardMicrobiologyMeningococcal endotoxin shockMRCPCH TAS

A 15-year-old has fever, purpuric rash, hypotension and meningococcal septicaemia. Lactate is high and coagulation is deranged. Which microbial component most directly drives the inflammatory shock?

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Correct answer: B — Lipooligosaccharide endotoxin

Neisseria meningitidis expresses lipooligosaccharide endotoxin, which can trigger intense cytokine release, capillary leak and disseminated intravascular coagulation. IgA protease supports mucosal colonisation but does not best explain fulminant septic shock. The pearl is that meningococcal disease can progress rapidly because of endotoxin-driven inflammation.

Reference: Nelson Textbook of Pediatrics; UKHSA Green Book; RCPCH Theory examination syllabi