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EBV Splenic Rupture — SCE Infectious Diseases MCQ

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HardRespiratory InfectionEBV Splenic RuptureSCE Infectious Diseases

Brucella melitensis is identified by valve PCR in culture-negative native-valve endocarditis after unpasteurised dairy exposure. Which directed regimen best matches the ESC table?

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

Reveal the answer and explanation

Correct answer: D — Use doxycycline, co-trimoxazole and rifampicin together for at least 3–6 months

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

B is correct. Brucella endocarditis needs prolonged intracellular combination therapy: ESC lists doxycycline, co-trimoxazole and rifampicin for at least three to six months; some experts add gentamicin for the first three weeks. A is the Bartonella schedule, C is neither the recommended combination nor duration, and D is the Coxiella/Tropheryma-style hydroxychloroquine regimen. E is inadequately supported and uses negative cultures as an unreliable stop rule in an often culture-negative disease. Serological response, valve destruction, relapse risk and surgical indications require specialist follow-up.

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