skip to main content

Refractory CSOM Management — SCE Infectious Diseases MCQ

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

HardRespiratory InfectionRefractory CSOM ManagementSCE Infectious Diseases

A 43-year-old with remote thymectomy for thymoma requires travel to a country with yellow-fever transmission and an entry certificate requirement. What is the correct vaccine decision?

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

Reveal the answer and explanation

Correct answer: E — Withhold STAMARIL and assess itinerary change or medical-waiver options

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

A is correct. A history of thymus dysfunction—including thymoma or thymectomy—is a contraindication to live yellow-fever vaccine because of the risk of severe vaccine-associated disease; elapsed time and a normal blood count do not reverse it. Fractional dosing or antibiotic cover does not solve the biological risk. A specialist travel assessment should explore avoidance or alteration of travel, mosquito precautions, and whether a medical waiver is acceptable to the destination authorities.

Reference: MHRA Drug Safety Update: yellow-fever vaccine and fatal adverse reactions: https://www.gov.uk/drug-safety-update/yellow-fever-vaccine-stamaril-and-fatal-adverse-reactions-extreme-caution-needed-in-people-who-may-be-immunosuppressed-and-those-60-years-and-older