skip to main content

AIN Treatment ANCHOR — SCE Infectious Diseases MCQ

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

HardHIV MedicineAIN Treatment ANCHORSCE Infectious Diseases

A man who has experienced homelessness presents with culture-negative aortic-valve endocarditis, glomerulonephritis and splenomegaly. Bartonella quintana PCR on excised valve tissue is positive and renal function permits an aminoglycoside. Which regimen matches ESC guidance?

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

Reveal the answer and explanation

Correct answer: B — Doxycycline 100 mg orally every 12 hours for 4 weeks plus gentamicin 3 mg/kg intravenously daily for the first 2 weeks

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

A is correct. ESC lists doxycycline 100 mg every 12 hours orally for four weeks plus gentamicin 3 mg/kg intravenously every 24 hours for the first two weeks for Bartonella endocarditis, with expected success of at least 90%. B substitutes rifampicin and lengthens doxycycline beyond the listed regimen. C resembles empirical culture-negative therapy rather than pathogen-directed Bartonella treatment. D is the prolonged intracellular regimen used for selected Coxiella or Tropheryma whipplei endocarditis, not Bartonella. E exposes the patient to six weeks of aminoglycoside toxicity instead of the recommended two. Drug levels, renal function, audiovestibular toxicity and surgical indications require Endocarditis-Team review.

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