A 10-year-old child in Rajasthan presents with 3 weeks of undulant fever, hepatosplenomegaly, and arthralgia. The family keeps cattle and the child drinks raw milk. Serology shows a standard tube agglutination test (STAT) for Brucella with a titre of 1:160. The MOST appropriate treatment regimen for brucellosis in this child is:
- A Doxycycline 100 mg twice daily for 6 weeks alone
- B Azithromycin 500 mg daily for 3 weeks
- C Doxycycline 100 mg twice daily + rifampicin 600–900 mg daily for 6 weeks ✓
- D Ciprofloxacin 500 mg twice daily for 4 weeks alone
Correct answer: C. Doxycycline 100 mg twice daily + rifampicin 600–900 mg daily for 6 weeks
Explanation
WHO-recommended treatment for uncomplicated brucellosis is doxycycline plus rifampicin for 6 weeks; this combination reduces relapse rates compared to doxycycline monotherapy. For children under 8 years where doxycycline is contraindicated, TMP-SMX plus rifampicin (or an aminoglycoside) is used. At age 10, doxycycline is generally accepted in many guidelines. The STAT titre of 1:160 in a febrile patient with appropriate exposure history is diagnostic. Monotherapy with any single agent is associated with higher relapse rates.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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