Mycology: actinomycetoma treatment: practice question

A Microbiology 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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Microbiology · Mycology: actinomycetoma treatment

Sample item

A 35-year-old farm worker has a swollen foot with multiple sinuses discharging red grains. Crushing a grain shows thin branching Gram-positive filaments less than 1 micrometre wide. Which treatment is appropriate?

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

The answer and the reasoning

B. Co-trimoxazole combined with amikacin

Thin filaments under 1 micrometre that are Gram-positive indicate actinomycetoma, caused by filamentous bacteria such as Actinomadura pelletieri (red grains) or Nocardia. Antibacterial combinations such as co-trimoxazole with amikacin are used, in contrast to eumycetoma, which needs antifungals and surgery.

Option by option

  • A. Intravenous amphotericin B for six weeks

    Amphotericin B has no role because the causative agent is a bacterium.

  • B. Co-trimoxazole combined with amikacin (correct)

    Correct. Actinomycetoma is bacterial and responds to prolonged antibacterial combinations.

  • C. Oral griseofulvin for six months

    Griseofulvin is used for dermatophyte infections and is not effective for mycetoma.

  • D. Itraconazole with wide surgical excision

    Itraconazole with excision is the approach for eumycetoma, where the filaments are broad.

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 Microbiology question

What is the answer to this Microbiology question?

The best answer is B, Co-trimoxazole combined with amikacin. Thin filaments under 1 micrometre that are Gram-positive indicate actinomycetoma, caused by filamentous bacteria such as Actinomadura pelletieri (red grains) or Nocardia.

Why is "Intravenous amphotericin B for six weeks" not the answer?

Amphotericin B has no role because the causative agent is a bacterium.

Why is "Oral griseofulvin for six months" not the answer?

Griseofulvin is used for dermatophyte infections and is not effective for mycetoma.

Why is "Itraconazole with wide surgical excision" not the answer?

Itraconazole with excision is the approach for eumycetoma, where the filaments are broad.

What concept does this question test?

It tests Mycology: actinomycetoma treatment in Microbiology. Antibacterial combinations such as co-trimoxazole with amikacin are used, in contrast to eumycetoma, which needs antifungals and surgery.

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 Mycology: actinomycetoma treatment?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology 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.