Infections: bacterial, viral, fungal, parasitic: gram-negative folliculitis: practice question

A Dermatology 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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Dermatology · Infections: bacterial, viral, fungal, parasitic: gram-negative folliculitis

Sample item

A 22-year-old on long-term oral doxycycline for acne has a sudden crop of pustules and cysts around the nose and cheeks that do not respond to the antibiotic. Gram stain of pus shows gram-negative rods. Which organisms are responsible?

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

The answer and the reasoning

C. Klebsiella or Enterobacter species

Gram-negative folliculitis is a complication of prolonged antibiotic therapy for acne, from nasal colonisation by Klebsiella, Enterobacter or Proteus. The antibiotic is stopped, and oral isotretinoin is the usual treatment.

Option by option

  • A. Malassezia furfur

    Malassezia is a yeast and causes pityrosporum folliculitis.

  • B. Staphylococcus aureus

    Staphylococcus aureus is gram-positive and would be suppressed by doxycycline.

  • C. Klebsiella or Enterobacter species (correct)

    Correct. Klebsiella and Enterobacter overgrow in the nose after prolonged tetracycline.

  • D. Cutibacterium acnes

    Cutibacterium acnes is gram-positive and causes ordinary acne.

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 Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Klebsiella or Enterobacter species. Gram-negative folliculitis is a complication of prolonged antibiotic therapy for acne, from nasal colonisation by Klebsiella, Enterobacter or Proteus.

Why is "Malassezia furfur" not the answer?

Malassezia is a yeast and causes pityrosporum folliculitis.

Why is "Staphylococcus aureus" not the answer?

Staphylococcus aureus is gram-positive and would be suppressed by doxycycline.

Why is "Cutibacterium acnes" not the answer?

Cutibacterium acnes is gram-positive and causes ordinary acne.

What concept does this question test?

It tests Infections: bacterial, viral, fungal, parasitic: gram-negative folliculitis in Dermatology. The antibiotic is stopped, and oral isotretinoin is the usual treatment.

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 Infections: bacterial, viral, fungal, parasitic: gram-negative folliculitis?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology 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.