Bacteriology: Brill-Zinsser disease: 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: Brill-Zinsser disease

Sample item

A 68-year-old man who survived epidemic typhus in a refugee camp decades ago now has a mild fever and rash, though there is no louse exposure. What explains this?

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

The answer and the reasoning

D. Recrudescence of latent Rickettsia prowazekii

Brill-Zinsser disease is recrudescent epidemic typhus from dormant R. prowazekii years after the primary illness, usually milder and without lice. Murine typhus is from fleas, scrub typhus from chiggers, and louse-borne relapsing fever from Borrelia.

Option by option

  • A. Primary infection with Orientia tsutsugamushi

    Orientia is transmitted by chiggers and needs a new exposure.

  • B. Recurrence of Borrelia recurrentis

    Borrelia recurrentis causes relapsing fever with febrile episodes, not a mild typhus-like rash.

  • C. Reinfection with Rickettsia typhi from fleas

    R. typhi needs a new flea exposure.

  • D. Recrudescence of latent Rickettsia prowazekii (correct)

    Correct. Latent R. prowazekii can reactivate years later.

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 Microbiology question

What is the answer to this Microbiology question?

The best answer is D, Recrudescence of latent Rickettsia prowazekii. Brill-Zinsser disease is recrudescent epidemic typhus from dormant R.

Why is "Primary infection with Orientia tsutsugamushi" not the answer?

Orientia is transmitted by chiggers and needs a new exposure.

Why is "Recurrence of Borrelia recurrentis" not the answer?

Borrelia recurrentis causes relapsing fever with febrile episodes, not a mild typhus-like rash.

Why is "Reinfection with Rickettsia typhi from fleas" not the answer?

R. typhi needs a new flea exposure.

What concept does this question test?

It tests Bacteriology: Brill-Zinsser disease in Microbiology. prowazekii years after the primary illness, usually milder and without lice. Murine typhus is from fleas, scrub typhus from chiggers, and louse-borne relapsing fever from Borrelia.

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: Brill-Zinsser disease?

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.