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Genital Herpes — SCE Infectious Diseases MCQ

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HardSTIsGenital HerpesSCE Infectious Diseases

After valve replacement and successful induction for fluconazole-susceptible Candida endocarditis, blood cultures remain negative. What longer-term antifungal principle should be anticipated?

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Correct answer: C — Long-term fluconazole suppression, potentially lifelong if prosthetic material remains

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

A is correct. Relapse after Candida endocarditis is well recognised, particularly with prosthetic material. ESC guidance supports prolonged oral azole suppression when the isolate is susceptible, sometimes lifelong, integrated with surgical outcome and specialist follow-up. A single negative culture is not a safe stopping point. Topical nystatin has no role in intravascular infection, and indefinite monthly echinocandin is neither a validated schedule nor a substitute for susceptibility-guided suppression.

Reference: ESC 2023 infective endocarditis guideline: https://academic.oup.com/eurheartj/article/44/39/3948/7243107