Try it
Dermatology · Infections: bacterial, viral, fungal, parasitic: actinomycetoma treatment
Sample itemA farmer has a swollen foot with multiple sinuses discharging red grains. Microscopy shows thin branching filaments that are Gram positive and modified acid-fast, and fungal culture is negative. Which regimen is appropriate?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Co-trimoxazole with amikacin
Actinomycetoma is caused by filamentous bacteria such as Nocardia and Actinomadura, so treatment is with antibacterial combinations such as co-trimoxazole with amikacin. Eumycetoma is fungal and needs prolonged azole therapy and often surgery.
Option by option
A. Griseofulvin
Griseofulvin acts on dermatophytes and has no antibacterial effect.
B. Co-trimoxazole with amikacin (correct)
Correct. Bacterial grains need antibacterials such as co-trimoxazole with amikacin.
C. Terbinafine alone
Terbinafine is an antifungal and is ineffective against Nocardia.
D. Itraconazole alone
Itraconazole acts on fungi and suits eumycetoma, not a bacterial filamentous 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.
More Dermatology questions
- Blistering disordersA patient has flaccid blisters that rupture easily and a positive Nikolsky sign. Which c…
- LeprosyIn which type of leprosy is the lepromin test strongly positive?
- Pigmentary disordersA man has well-demarcated chalk-white macules on his hands and around his mouth. A skin…
- Drug reactionsWhich of the following drugs is a well-recognised trigger of Stevens–Johnson syndrome an…