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Brucellosis Treatment Duration — SCE Infectious Diseases MCQ

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EasyTropical & Imported InfectionsBrucellosis Treatment DurationSCE Infectious Diseases

A 55-year-old man presents with chronic granulomatous hepatitis. Liver biopsy shows non-caseating epithelioid granulomata. AFB stain is negative. He has a history of exposure to unpasteurised goat cheese in the Mediterranean. Brucella serology (SAT) shows a titre of 1:640. What is the recommended treatment duration?

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Correct answer: B — Doxycycline 100 mg BD plus Rifampicin 600–900 mg daily for 6 weeks — minimum duration for uncomplicated brucellosis

Brucellosis (from unpasteurised dairy, a zoonosis endemic to the Mediterranean, Middle East, and Central Asia) causing granulomatous hepatitis requires combination therapy to prevent relapse. WHO recommends Doxycycline 100 mg BD for 6 weeks PLUS either Rifampicin 600–900 mg daily for 6 weeks OR Streptomycin/Gentamicin IM for 2–3 weeks. Monotherapy has unacceptable relapse rates. For complicated brucellosis (spondylitis, endocarditis, neurobrucellosis), longer courses and triple therapy may be needed.

Reference: WHO 2020 – Brucellosis; BIA 2017 – Brucellosis management