Bacteriology: Burkholderia pseudomallei: 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 · Bacteriology: Burkholderia pseudomallei

Sample item

A 52-year-old diabetic rice farmer from coastal Karnataka presents in the monsoon with fever, pneumonia and multiple liver and subcutaneous abscesses. Culture shows oxidase-positive, bipolar-staining Gram-negative bacilli forming wrinkled colonies. Which therapy is appropriate for the initial intensive phase?

AIntravenous ceftazidime or meropenemBIntravenous gentamicin aloneCOral amoxicillin for 5 daysDOral doxycycline alone

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

The answer and the reasoning

A. Intravenous ceftazidime or meropenem

Melioidosis, caused by Burkholderia pseudomallei from soil and water, occurs in diabetics and other hosts during the rainy season in endemic coastal regions. The intensive phase uses intravenous ceftazidime or meropenem for at least 10 to 14 days, followed by eradication therapy with cotrimoxazole for several months to prevent relapse. The organism is intrinsically resistant to aminoglycosides and many other drugs.

Option by option

A. Intravenous ceftazidime or meropenem (correct)
Correct. Ceftazidime or a carbapenem is the intensive-phase backbone.
B. Intravenous gentamicin alone
Aminoglycosides are intrinsically ineffective against B. pseudomallei.
C. Oral amoxicillin for 5 days
Oral amoxicillin for 5 days is inadequate; the organism is resistant to it and this is a severe disseminated infection.
D. Oral doxycycline alone
Doxycycline alone is not adequate for severe disease; it is only a possible alternative in the long eradication phase.

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 Microbiology question

What is the answer to this Microbiology question?

The best answer is A, Intravenous ceftazidime or meropenem. Melioidosis, caused by Burkholderia pseudomallei from soil and water, occurs in diabetics and other hosts during the rainy season in endemic coastal regions.

Why is "Intravenous gentamicin alone" not the answer?

Aminoglycosides are intrinsically ineffective against B. pseudomallei.

Why is "Oral amoxicillin for 5 days" not the answer?

Oral amoxicillin for 5 days is inadequate; the organism is resistant to it and this is a severe disseminated infection.

Why is "Oral doxycycline alone" not the answer?

Doxycycline alone is not adequate for severe disease; it is only a possible alternative in the long eradication phase.

What concept does this question test?

It tests Bacteriology: Burkholderia pseudomallei in Microbiology. The intensive phase uses intravenous ceftazidime or meropenem for at least 10 to 14 days, followed by eradication therapy with cotrimoxazole for several months to prevent relapse. The organism is intrinsically resistant to aminoglycosides and many other drugs.

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 Bacteriology: Burkholderia pseudomallei?

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.