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Prolonged fever, UTI and typhoid - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
User :   Please type your query here. Since this query is directed to our panel of specialists and super-specialists, please mention your problem in as much detail as possible. Do not forget to highlight your Age, Gender, Medical History and Treatment History of the problem you are facing
Doctor :   Hi
Doctor :   How can I help you?
User :   My son ( age 15 ) had fever about 2 months back on 2/3/2010.
User :   Paracetemol was given and the doctor advised blood & urine test
Doctor :   Ok
User :   urine & blood report came on 10/3/2010 . Urine report : Pus cells were 4-6. Blood report : SALMONELLA TYPHI -O ...1:80 dilution SALMONELLA TYPHI-H â?¦1:80 dilution SALMONELLA TYPHI A-H â?¦ NEGETIVE SALMONELLA TYPHI B-H â?¦ NEGETIVE
Doctor :   Ok
User :   Treated for urinary infection. ( antibiotic- Zufi 200mg )
Doctor :   Ok
User :   Fever continued. antibiotic continued. The doctor advised urine routine and culture test.
Doctor :   Ok
User :   Report came on 31/3/2010 Urine report : Urine culture â?? no growth Pus cells 1-2
Doctor :   Ok
User :   Fever continued. As the boy had school examination, only paracetemol was given .
Doctor :   Ok
User :   After school examination, paracetemol was stopped and temperature was noted . Fever was there. Doctor advised for Blood culture, TCDC,Widal, LFT, Urine routine, U/ Scanning of abdomen and pelvis.
Doctor :   Ok
User :   Report came on 13/4/2010 Urine report : Pus cells 1-2 U/S report : Liver, gall bladder, pancreas, spleen, kidneys, prostrate â?¦.normal No sonographic abnormality
Doctor :   Ok
User :   Blood test : Liver functionality test : normal Blood culture â?¦no growth Widal test: SALMONELLA TYPHI -O â?¦...1:160 dilution SALMONELLA TYPHI-H â?¦ 1:160 dilution SALMONELLA TYPHI A-H â?¦ NEGETIVE SALMONELLA TYPHI B-H â?¦ NEGETIVE
Doctor :   Ok
User :   Antibiotic for Typhoid ( Cifron 500 mg ) with paracetemol was started on 13/4/2010 Up to 19/4/2010 and paracetemol was stopped and temperature was noted. It was going up to 99.8 during noon
Doctor :   Ok
User :   Antibiotic was continued up to 29/4/2010 and doctor advised to take blood test and urine test
User :   Urine report : Pus cells 1-2
Doctor :   Ok
User :   Blood test : SALMONELLA TYPHI -O â?¦...1:80 dilution
User :   SALMONELLA TYPHI-H â?¦ 1:80 dilution
User :   SALMONELLA TYPHI A-H â?¦ NEGETIVE SALMONELLA TYPHI B-H â?¦ NEGETIVE
Doctor :   Ok
User :   Doctor has told typhoid has gone but asked to continue antibiotic for another 3 days and keep a note on temperature.
User :   But today , 1/5/ 2010, the temperature was normal in morning and started rising and s gone up to 100.2 in the evening and come down.
Doctor :   Ok
User :   r u there doctor?
Doctor :   Yes.
User :   If typhoid has gone , why the temperature is not coming down to normal ?
Doctor :   I am here.
User :   If typhoid has gone , why the temperature is not coming down to normal ?
User :   He is taking antibiotic from 13/4/2010 . Still how many days he has to take antibiotic?
Doctor :   May I know the name of the antibiotic used for the treatment of typhoid.
User :   cifron 500mg
User :   1-1-1
Doctor :   Ok
Doctor :   Let me explain it to you.
User :   He is taking antibiotic from 13/4/2010 . Still how many days he has to take antibiotic?
User :   ok sir
Doctor :   As per the reports, there would have be two source of infection during the whole month.
User :   ok
Doctor :   First it would have been the urinary infection and then the typhoid.
User :   yes
Doctor :   Since he was no an antibiotic before the culture test were done, the significance of the blood culture is doubtful.
User :   ok
Doctor :   It is only the culture test, that would be predicting the right antibiotic that would have to be given to treat the typhoid completely.
User :   ok
Doctor :   Now, there can be two possible reason for the aggravation of the fever.
Doctor :   1. Recurrence of typhoid.
User :   tell me sir
User :   is it possible?
User :   after so many tablets?
Doctor :   or the second possibility would be incomplete treatment.
User :   you mean?
Doctor :   These two possibilities are definitely possible.
User :   so he has to take some more antibiotics?
Doctor :   I would suggest you to continue with the antibiotics as suggested by your doctor and if the fever is still persisting to get the widal test repeated.
User :   ok.
Doctor :   This would confirm if the cause for the fever right now is due to either of the causes.
User :   once it showd clear 1: 80
User :   means typhoid has gone no?
Doctor :   Yes, that would mean the infection is going down, however
Doctor :   recurrence is still possible.
User :   shoud it come negetive ?
User :   instead of 1:80 ?
Doctor :   A reduction in the widal titre is sufficient to explain the control of infection.
User :   y it will re occur ? he is on strict diet
Doctor :   But since you say the fever has started again, this can be possible too.
User :   is typhoid prolongs for months together ?
Doctor :   Yes, typhoid can last for months.
User :   how many days a boy (15years ) can take antibiotic? no problem?
User :   what diet he has to follow ? we r not giving ant spicy food.
User :   r u there doctor?
Doctor :   There are no other dietary restriction apart for reduction in the spices.
User :   how many days a boy (15years ) can take antibiotic? no problem?
Doctor :   This restriction is only to prevent gastritis due to the use of antibiotics and not as prevention of the infection.
Doctor :   SO there is no other restriction.
User :   y typhoid reattacks?
Doctor :   Give him plenty of fruits and vegetables.
User :   he is not at all going out taking rest
Doctor :   I cannot predict the exact cause for recurrence, however, the cause can be due to improper treatment or due to a fresh infection.
Doctor :   Theorectically there is another possibility,
User :   we are giving barley water, rice gaunge, enerzol and b complex
User :   which fruits he has to take? citrous fruits also?
Doctor :   Salmonella infection can live in the gall bladder of the person and once the antibiotic cover is removed this can spread causing the infection to recurr.
User :   oh...
Doctor :   Yes, there is no restrictions in the fruits.
User :   not from out side
User :   so infection from inside
Doctor :   That could be possible too.
User :   ok.....
User :   any other advice doctor?
Doctor :   Hence, I would suggest you to continue with the paracetamol when ever he gets fever.
User :   nothing to worry?
Doctor :   2. If the antibiotic course is not finished, then continue with them, as suggested by his doctor.
Doctor :   3. The fever should be coming down in a day or two with this, but if it persists or his he gets high grade fever, he would need a repeat widal test.
Doctor :   Have you followed with what I have suggested?
Doctor :   Are you there?
Doctor :   I have to close the window as you are not responding. Please chat with our doctors 24/7 for medical queries.
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