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Difficulty: EasyInfectious Diseases

Match each clinical presentation with its most appropriate first-line antimicrobial therapy.

  • A 24-year-old man presents with a solitary, painless, indurated ulcer on his glans penis. Dark-field microscopy of the exudate shows motile spirochetes.Intramuscular benzathine penicillin G
  • A 30-year-old woman presents with a slowly expanding, flat, erythematous rash with central clearing on her thigh, one week after a camping trip.Oral doxycycline
  • A 21-year-old man presents with dysuria and purulent urethral discharge. Gram stain reveals neutrophils and intracellular Gram-negative diplococci.Intramuscular ceftriaxone
  • A 45-year-old man presents with a painful, fluctuant skin abscess on his lower leg. He requires oral antibiotics covering community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA).Oral trimethoprim-sulfamethoxazole

Answer

Primary syphilis matches with benzathine penicillin G; early Lyme disease matches with doxycycline; gonococcal urethritis matches with ceftriaxone; and CA-MRSA skin infection matches with trimethoprim-sulfamethoxazole.
Each clinical scenario presents a classic presentation of a common outpatient infection. The pairings reflect the standard-of-care first-line antimicrobial therapies for these specific pathogens, adhering to current clinical guidelines and antibiotic stewardship principles.

Step-by-Step Solution

1
Diagnose the underlying infectious syndrome for each clinical vignette.
Patient 1 has primary syphilis, Patient 2 has early localized Lyme disease, Patient 3 has gonococcal urethritis, and Patient 4 has a CA-MRSA skin abscess.
Accurate pathogen identification or syndrome recognition is required for appropriate antimicrobial selection.
2
Select the guideline-recommended first-line therapy for each diagnosis.
Syphilis requires benzathine penicillin G. Lyme disease requires doxycycline. Gonorrhea requires ceftriaxone. CA-MRSA requires an agent like trimethoprim-sulfamethoxazole.
Following established treatment guidelines ensures maximum efficacy and supports antibiotic stewardship.

Key Concept

Empiric and targeted antimicrobial therapy for common outpatient infectious diseases.
Estimated Time:1m 30s
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Topics

Infectious Diseases

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