Trauma and burns: invasive burn wound infection: practice question

A General Surgery 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 Surgery · Trauma and burns: invasive burn wound infection

Sample item

On day 8 after a 40 percent burn, a patient develops fever, hypotension and ileus. The wound shows focal dark discolouration, haemorrhagic areas and early eschar separation. What confirms the diagnosis of invasive burn wound infection?

AA raised C-reactive proteinBBiopsy showing a high count of organisms invading viable tissueCA positive surface swab cultureDA single positive blood culture

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

The answer and the reasoning

B. Biopsy showing a high count of organisms invading viable tissue

Invasive burn wound sepsis is diagnosed by tissue biopsy showing microorganisms invading adjacent viable tissue, typically with more than 10^5 organisms per gram. Surface swabs reflect colonisation, which is universal in burns. Treatment includes excision and systemic and topical antimicrobials.

Option by option

A. A raised C-reactive protein
CRP is raised by any inflammation, including the burn itself.
B. Biopsy showing a high count of organisms invading viable tissue (correct)
Correct. Histology and quantitative culture of a biopsy show invasion of viable tissue.
C. A positive surface swab culture
Burn wounds are colonised, so a positive swab does not prove invasion.
D. A single positive blood culture
Blood cultures may be negative or positive and do not confirm wound invasion.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Biopsy showing a high count of organisms invading viable tissue. Invasive burn wound sepsis is diagnosed by tissue biopsy showing microorganisms invading adjacent viable tissue, typically with more than 10^5 organisms per gram.

Why is "A raised C-reactive protein" not the answer?

CRP is raised by any inflammation, including the burn itself.

Why is "A positive surface swab culture" not the answer?

Burn wounds are colonised, so a positive swab does not prove invasion.

Why is "A single positive blood culture" not the answer?

Blood cultures may be negative or positive and do not confirm wound invasion.

What concept does this question test?

It tests Trauma and burns: invasive burn wound infection in General Surgery. Surface swabs reflect colonisation, which is universal in burns. Treatment includes excision and systemic and topical antimicrobials.

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 Trauma and burns: invasive burn wound infection?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.