Paediatric infections: scrub typhus: practice question

A Pediatrics 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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Pediatrics · Paediatric infections: scrub typhus

Sample item

A 7-year-old from a rural area has had fever for 8 days. An eschar is seen in the axilla with tender regional lymphadenopathy, thrombocytopenia and raised transaminases. Which drug is the treatment of choice?

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

The answer and the reasoning

B. Doxycycline

Scrub typhus is caused by Orientia tsutsugamushi, transmitted by the bite of larval mites (chiggers), and the eschar is a clue. Doxycycline is the drug of choice and gives a rapid fall of fever, including in children, with azithromycin as an alternative. Delayed treatment risks pneumonitis, meningoencephalitis and multi-organ failure.

Option by option

  • A. Chloroquine

    Chloroquine treats malaria and does not treat rickettsial disease.

  • B. Doxycycline (correct)

    Correct. Doxycycline treats rickettsial infections and gives a response within 48 hours.

  • C. Ceftriaxone

    Cephalosporins are ineffective against Orientia.

  • D. Penicillin G

    Penicillin does not act on this intracellular organism.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Doxycycline. Scrub typhus is caused by Orientia tsutsugamushi, transmitted by the bite of larval mites (chiggers), and the eschar is a clue.

Why is "Chloroquine" not the answer?

Chloroquine treats malaria and does not treat rickettsial disease.

Why is "Ceftriaxone" not the answer?

Cephalosporins are ineffective against Orientia.

Why is "Penicillin G" not the answer?

Penicillin does not act on this intracellular organism.

What concept does this question test?

It tests Paediatric infections: scrub typhus in Pediatrics. Doxycycline is the drug of choice and gives a rapid fall of fever, including in children, with azithromycin as an alternative. Delayed treatment risks pneumonitis, meningoencephalitis and multi-organ failure.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Paediatric infections: scrub typhus?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.