Neisseria meningitidis Quiz: Ace Your Exams

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A 24-year-old male college student is brought to the emergency department by his roommate due to confusion and altered mental status. His roommate says that the patient was in his usual state until 2 days ago, when he started complaining of headaches and fatigue. Temperature is 39.0°C (102.2°F), pulse is 100/min, and blood pressure is 135/85 mmHg. On physical examination, the patient is disoriented, and nuchal rigidity is noted. Examination of the patient’s left leg is shown below, and similar lesions are seen on the contralateral leg and bilateral arms:  


Reproduced from: Wikimedia Commons

Which of the following is the most likely point of entry of the pathogen responsible for this patient’s condition?

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