Match each clinical presentation with the most appropriate first-line targeted antimicrobial therapy.
- A 34-year-old man presenting with a deep puncture wound to the plantar surface of his foot after stepping on a rusty nail through a rubber-soled athletic shoe.Oral ciprofloxacin
- A 28-year-old veterinary technician presenting with a rapidly spreading, painful, erythematous wound infection on her hand 24 hours after a cat bite.Oral amoxicillin-clavulanate
- A 45-year-old woman presenting with high fever, myalgias, leukopenia, and thrombocytopenia one week after a tick bite, without any visible rash.Oral doxycycline
- A 26-year-old pregnant woman in her third trimester presenting with acute fever; initial blood cultures grow a motile, non-spore-forming Gram-positive bacillus.Intravenous ampicillin
- A 32-year-old man presenting with copious purulent urethral discharge; Gram stain of the exudate reveals abundant neutrophils containing Gram-negative intracellular diplococci.Single dose of intramuscular ceftriaxone
Answer
The correct pairings match the sneaker puncture to oral ciprofloxacin, the cat bite to oral amoxicillin-clavulanate, the tick-borne illness to oral doxycycline, the Listeria bacteremia to intravenous ampicillin, and the gonococcal urethritis to intramuscular ceftriaxone.
Each correct pair links a specific clinical infectious disease vignette with its guideline-directed medical therapy. Sneaker puncture wounds uniquely require anti-pseudomonal coverage (ciprofloxacin). Cat bites require Pasteurella and polymicrobial coverage (amoxicillin-clavulanate). Ehrlichiosis requires intracellular coverage (doxycycline). Listeriosis in pregnancy requires targeted coverage (ampicillin). Uncomplicated gonococcal urethritis requires a third-generation cephalosporin (ceftriaxone).
Step-by-Step Solution
Key Concept
Appropriate selection of targeted antimicrobial therapy based on specific pathogen exposures and clinical presentations.