A farmer from southern India presents with high fever, Eschar over the groin, lymphadenopathy and thrombocytopenia. Scrub typhus caused by Orientia tsutsugamushi is confirmed. The recommended first-line treatment is:
- A Gentamicin
- B Doxycycline ✓
- C Metronidazole
- D Amoxicillin-clavulanate
Correct answer: B. Doxycycline
Explanation
Rickettsial and Orientia infections are classic indications for tetracyclines. Doxycycline is the drug of choice for scrub typhus and all rickettsial diseases, given orally twice daily, and is safe even in children when used short course. Beta-lactams are ineffective because these organisms are intracellular and lack a conventional peptidoglycan wall, and aminoglycosides cannot penetrate host cells. Chloramphenicol and azithromycin are alternatives when doxycycline is contraindicated.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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