Match the following clinical vignettes describing zoonotic and environmental infections with their most appropriate targeted antimicrobial therapy.
- A 45-year-old livestock veterinarian with a 4-week history of undulating fevers, profound fatigue, night sweats, and hepatosplenomegaly.Prolonged course of oral doxycycline and rifampin
- A 34-year-old landscaper from Arkansas with sudden-onset fever and chills, followed by a demarcated ulcer on his right index finger and severe right axillary lymphadenopathy.Intravenous or intramuscular gentamicin
- A 29-year-old triathlete with abrupt-onset high fever, severe calf myalgias, and marked conjunctival suffusion three days after a freshwater swimming event.Intravenous penicillin G
- A 22-year-old veterinary technician with a localized papule on her forearm that progressed to tender, fluctuant epitrochlear lymphadenopathy over three weeks.Oral azithromycin
- A 41-year-old wool sorter with a painless, pruritic macule on his forearm that rapidly enlarged into a central black eschar surrounded by extensive, non-pitting edema.Oral ciprofloxacin
Cevap
Brucellosis matches with doxycycline and rifampin. Tularemia matches with gentamicin. Leptospirosis matches with intravenous penicillin G. Cat scratch disease matches with azithromycin. Cutaneous anthrax matches with ciprofloxacin.
Each clinical vignette provides highly specific occupational or environmental exposures paired with classic physical exam findings that uniquely identify a specific zoonotic bacterial pathogen. The correct pairings reflect the current gold standard first-line therapies for these respective pathogens based on their intrinsic sensitivities and intracellular characteristics.
Adım Adım Çözüm
Anahtar Kavram
Diagnosis and targeted antimicrobial therapy of zoonotic and environmental bacterial infections.