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Question

Difficulty: EasyInfectious Diseases

Match each classic clinical presentation of an infectious disease with its most appropriate first-line pharmacotherapy.

  • A 26-year-old man with a painless, indurated genital ulcer and non-tender inguinal lymphadenopathyIntramuscular benzathine penicillin G
  • A 32-year-old woman with an expanding, targetoid erythematous rash on her leg following a tick biteOral doxycycline
  • A 12-year-old boy with acute onset of fever, tonsillar exudates, and tender anterior cervical adenopathy without a coughOral amoxicillin
  • A 19-year-old athlete with a painful, fluctuant, purulent skin abscess on his leg requiring drainageOral trimethoprim-sulfamethoxazole

Answer

The presentations map to their respective first-line therapies: primary syphilis with benzathine penicillin G, early Lyme disease with doxycycline, streptococcal pharyngitis with amoxicillin, and community-acquired MRSA with trimethoprim-sulfamethoxazole.
Each clinical vignette provides pathognomonic or highly specific features for a common infection, which precisely corresponds to a well-established, guideline-directed first-line antimicrobial agent.

Step-by-Step Solution

1
Diagnose the infectious disease described in each clinical vignette based on classic signs and symptoms.
The vignettes sequentially describe primary syphilis, early localized Lyme disease, group A streptococcal pharyngitis, and a community-acquired MRSA skin abscess.
Accurate clinical pattern recognition is the necessary first step before selecting empiric antimicrobial therapy.
2
Identify the guideline-recommended, first-line antimicrobial agent for each diagnosed condition.
Primary syphilis requires benzathine penicillin G; Lyme disease requires doxycycline; Streptococcal pharyngitis requires amoxicillin; CA-MRSA requires trimethoprim-sulfamethoxazole.
Using targeted, first-line therapy ensures clinical efficacy while adhering to antimicrobial stewardship principles by avoiding unnecessarily broad coverage.

Key Concept

Empiric antimicrobial selection for common outpatient infectious diseases based on classic clinical presentations.
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Topics

Infectious Diseases

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