MKSAP: 25-year-old woman is evaluated for redness at mosquito bite

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 25-year-old woman is evaluated for redness that developed over her right leg at the site of a mosquito bite. She is otherwise healthy and takes no medications.

On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 120/70 mm Hg, pulse rate is 70/min, and respiration rate is 14/min. There is an erythematous 3 × 3-cm patch on the right thigh. The area is warm to the touch with no evidence of purulence, fluctuance, crepitus, or lymphadenopathy.

Which of the following is the most appropriate empiric outpatient therapy?

A: Cephalexin

B: Doxycycline

C: Fluconazole

D: Metronidazole

E: Trimethoprim-sulfamethoxazole

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