Infectious diseases: rickettsial infection: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Infectious diseases: rickettsial infection

Sample item

A farmer from a rural area has 6 days of fever, headache, myalgia and a dark scab with a surrounding red halo on the groin, with tender regional lymph nodes. He has no response to a beta-lactam. Which drug is the treatment of choice?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Doxycycline

Scrub typhus, caused by Orientia tsutsugamushi and transmitted by trombiculid mite larvae, is common in India. An eschar suggests the diagnosis. Doxycycline is the drug of choice, with azithromycin as an alternative in pregnancy and children, and it often produces defervescence within 48 hours. Beta-lactams are ineffective against intracellular rickettsiae.

Option by option

  • A. Ceftriaxone

    Ceftriaxone has no activity against Orientia.

  • B. Chloroquine

    Chloroquine treats malaria, not rickettsial infection.

  • C. Ciprofloxacin

    Ciprofloxacin is not reliably effective against scrub typhus.

  • D. Doxycycline (correct)

    Correct. Doxycycline is the treatment of choice for rickettsial infection.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Doxycycline. Scrub typhus, caused by Orientia tsutsugamushi and transmitted by trombiculid mite larvae, is common in India.

Why is "Ceftriaxone" not the answer?

Ceftriaxone has no activity against Orientia.

Why is "Chloroquine" not the answer?

Chloroquine treats malaria, not rickettsial infection.

Why is "Ciprofloxacin" not the answer?

Ciprofloxacin is not reliably effective against scrub typhus.

What concept does this question test?

It tests Infectious diseases: rickettsial infection in General Medicine. An eschar suggests the diagnosis. Doxycycline is the drug of choice, with azithromycin as an alternative in pregnancy and children, and it often produces defervescence within 48 hours. Beta-lactams are ineffective against intracellular rickettsiae.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infectious diseases: rickettsial infection?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.