Name: Ryosuke Yamada

Theme: Zoonoses

 

OPTION LIST

A

Azithromycin PO

I

Norfloxacin PO

B

Chloramphenicol IV

J

Supportive care

C

Ciprofloxacin PO

K

Trimethoprim-sulfamethoxazole PO

D

Doxycycline IV

L

 

E

Doxycycline PO

M

 

F

Erythromycin IV

N

 

G

Erythromycin PO

O

 

H

Ibuprofen

P

 

 

For each scenario below, choose the most appropriate treatment from the list above. Each option may be used once, more than once or not at all.

 

1. A 21 yr-old student, who has just returned from geography trip to Pennsylavania in August, presents with a few day history of expanding 5cm “bull’s-eye” rash on his arm. The culture from the skin lesion showed weakly staining gram-negative spirochetes.

 

2. A 50 yr-old traveller returning from India has presented to A+E with high fever and headache. The patient is also complaining of bright lights and neck stiffness. On examination, he has painful axillary lymph node swelling and positive Kernig’s sign.

 

3. A 14 yr-old girl presents to GP with a week history of general tiredness and one day history of mild fever (38.3ºC) and no other sign of note.

Four days later, she returns to her GP with the same symptoms despite oral erythromycin which the GP had prescribed to her. Furthermore, blood culture is negative for organisms, and history review uncovers presence of a pet kitten.

 

4. A 30 yr-old Maltese farmer presents to A+E with acute onset fever and painful joints. On examination, he has one-finger breadth splenomegaly. Laboratory diagnosis shows non-encapsulated gram-negative bacilli with catalase and oxidase positivity.

 

5. A 27 yr-old pregnant American farmer with the same diagnosis as 4.

 

ANSWERS

1. E

2. B

3. H

4. E

5. K