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Scrub typhus — DTM&H MCQ

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HardTropical bacterial infectionsScrub typhusDTM&H

A trekker in northern Thailand has fever, thrombocytopenia, mild hepatitis and an eschar hidden in the groin. Which empirical treatment best targets the leading diagnosis while confirmatory testing is arranged?

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

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Correct answer: D — Doxycycline for scrub typhus

The best answer is “Doxycycline for scrub typhus”. An eschar after scrub exposure with thrombocytopenia and transaminitis strongly suggests Orientia tsutsugamushi infection. Doxycycline is active against rickettsial infections and treatment should not be delayed when clinical suspicion is high because severe organ involvement can evolve rapidly.

Reference: Doxycycline 100 mg capsules, UK Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/13082/smpc