Bacterial infections: scrub typhus: 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 · Bacterial infections: scrub typhus

Sample item

A trekker in the Himalayan foothills has fever, headache and a painless black eschar in the axilla with tender regional lymph nodes. Which drug is best for this illness?

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

The answer and the reasoning

A. Doxycycline

The eschar and exposure point to scrub typhus due to Orientia tsutsugamushi, transmitted by chigger mites. Doxycycline is the drug of choice, with azithromycin as an alternative in pregnancy and children.

Option by option

  • A. Doxycycline (correct)

    Correct. Tetracyclines act on these obligate intracellular bacteria.

  • B. Ceftriaxone

    Beta-lactams such as ceftriaxone are not effective against rickettsiae.

  • C. Amoxicillin

    Amoxicillin lacks activity against intracellular rickettsiae.

  • D. Gentamicin

    Aminoglycosides do not reach adequate intracellular levels against Orientia.

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 A, Doxycycline. The eschar and exposure point to scrub typhus due to Orientia tsutsugamushi, transmitted by chigger mites.

Why is "Ceftriaxone" not the answer?

Beta-lactams such as ceftriaxone are not effective against rickettsiae.

Why is "Amoxicillin" not the answer?

Amoxicillin lacks activity against intracellular rickettsiae.

Why is "Gentamicin" not the answer?

Aminoglycosides do not reach adequate intracellular levels against Orientia.

What concept does this question test?

It tests Bacterial infections: scrub typhus in Dermatology. Doxycycline is the drug of choice, with azithromycin as an alternative in pregnancy and children.

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 Bacterial infections: scrub typhus?

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.