Infectious diseases: melioidosis: 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.

Try it

General Medicine · Infectious diseases: melioidosis

Sample item

A 52-year-old diabetic rice farmer has fever, cough and multiple abscesses in the liver and spleen. Culture grows an oxidase-positive Gram-negative bacillus showing bipolar safety-pin staining. Which treatment is appropriate for the initial intensive phase?

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

The answer and the reasoning

A. Intravenous ceftazidime or meropenem

This is melioidosis, caused by Burkholderia pseudomallei and common in diabetic farmers in endemic regions. The intensive phase uses intravenous ceftazidime or a carbapenem for 2 weeks or longer, followed by prolonged oral eradication therapy.

Option by option

  • A. Intravenous ceftazidime or meropenem (correct)

    Correct. Ceftazidime or meropenem is standard intensive-phase therapy.

  • B. Oral azithromycin

    Azithromycin is not an effective treatment for this infection.

  • C. Oral amoxicillin

    Amoxicillin is inadequate and the organism is intrinsically resistant to many oral agents.

  • D. Intravenous benzylpenicillin

    Benzylpenicillin lacks activity against this organism.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Intravenous ceftazidime or meropenem. This is melioidosis, caused by Burkholderia pseudomallei and common in diabetic farmers in endemic regions.

Why is "Oral azithromycin" not the answer?

Azithromycin is not an effective treatment for this infection.

Why is "Oral amoxicillin" not the answer?

Amoxicillin is inadequate and the organism is intrinsically resistant to many oral agents.

Why is "Intravenous benzylpenicillin" not the answer?

Benzylpenicillin lacks activity against this organism.

What concept does this question test?

It tests Infectious diseases: melioidosis in General Medicine. The intensive phase uses intravenous ceftazidime or a carbapenem for 2 weeks or longer, followed by prolonged oral eradication therapy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: melioidosis?

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.