skip to main content

Necrotising Otitis Externa — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

HardRespiratory InfectionNecrotising Otitis ExternaSCE Infectious Diseases

Granulicatella adiacens prosthetic-aortic-valve endocarditis is penicillin susceptible. There is no immediate surgical indication and renal function is normal. Which antimicrobial principle matches ESC guidance?

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

Reveal the answer and explanation

Correct answer: C — Give penicillin G, ceftriaxone or vancomycin for 6 weeks, with an aminoglycoside for at least 2 weeks

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

A is correct. Granulicatella and Abiotrophia are nutritionally variant streptococci associated with large vegetations, complications and valve replacement. ESC recommends penicillin G, ceftriaxone or vancomycin for six weeks, with an aminoglycoside for at least the first two weeks in prosthetic-valve endocarditis. Four weeks is too short for this prosthetic infection, rifampicin is not automatically added to every PVE, and extending gentamicin through all six weeks adds toxicity without matching the recommendation. Endocarditis-Team review and repeat imaging remain important because microbiological susceptibility does not make this a low-risk organism.

Reference: ESC 2023 guideline for the management of endocarditis: https://academic.oup.com/eurheartj/article/44/39/3948/7243107