A 34-year-old farmer presents with high fever, severe headache and an eschar over his groin after working in a paddy field in Tamil Nadu. Weil-Felix test is positive. The drug of choice for his condition is:
- A Azithromycin
- B Ceftriaxone
- C Doxycycline ✓
- D Metronidazole
Correct answer: C. Doxycycline
Explanation
Scrub typhus caused by Orientia tsutsugamushi responds dramatically to doxycycline, which remains the standard drug of choice in India; defervescence within 24 to 48 hours is typical. Rickettsiae are obligate intracellular organisms, and tetracyclines concentrate inside host cells where they inhibit ribosomal protein synthesis. Azithromycin is a second-line alternative in pregnancy or doxycycline intolerance, and ceftriaxone has no activity against Orientia.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.