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Amoebiasis — SCE Infectious Diseases MCQ

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HardTropical & Imported InfectionsAmoebiasisSCE Infectious Diseases

A patient with suspected Lyme carditis presents with complete heart block, a ventricular escape rate of 32/min, hypotension and presyncope. Which antimicrobial regimen is the appropriate initial choice?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Ceftriaxone 2 g intravenously daily for 21 days, switching to doxycycline when stable

Explanation lettering: B = shown as A · C = shown as B · E = shown as C · A = shown as D · D = shown as E

B is correct. Haemodynamic instability makes this severe Lyme carditis. NICE recommends ceftriaxone 2 g intravenously once daily for 21 days, with a switch to oral doxycycline considered once stable. The patient simultaneously needs monitored cardiac care and pacing assessment; pacing does not replace antimicrobial treatment. Unmonitored oral therapy is unsafe initially, 28 days is the arthritis schedule, and complete block does not convert Lyme carditis into infective endocarditis requiring six weeks.

Reference: NICE NG95: Lyme disease recommendations: https://www.nice.org.uk/guidance/ng95/chapter/Recommendations