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Having fever. Advised to do blood test. Diagnosed with S typhi. What are the precautions to be taken?

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General & Family Physician
Practicing since : 2009
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Hi Doctor, my wife is having a fever since 4 days so Dr. adviced to do blood test and it was diagnosed as S typhi "O" : 1:160 Dil (positive) and S typhi "H" :1: 160 Dil (positive). Every night she has 101 to 103 temperature. What precautions needs to be taken ? What would you suggest as a medical treatment in this case?
Posted Thu, 7 Nov 2013 in Medicines and Side Effects
Answered by Dr. Yogesh D 26 minutes later
Brief Answer:
Single reading of WIDAL titres is not conclusive.

Detailed Answer:

Thanks for the query.

Though a single reading of WIDAL titres is not conclusive of typhoid, I would say, I high enough titre like the one in your wife's case points strongly to recent or ongoing typhoid infection. That said, a serial WIDAL titre would conclusively prove typhoid if it goes up from the current levels.

The gold standard for diagnosing typhoid still is a blood culture, if a blood culture is positive for typhoid then it will mean 100% that she is suffering from typhoid.

Now coming to your question.

1. Your wife will need a course of antibiotics. Depending on the medicine, the duration varies. I prescribe Cefpodoxime 200 mg twice a day for 14 to 21 days to my patients, depending on the clinical course of the disease. Currently this is the drug of choice for typhoid. There are other drugs which are approved for usage in typhoid, like Azithromycin, Ceftriaxone, Cefexime, you need to talk to your doctor regarding the same.

2. For symptomatic relief, I prescribe paracetamol 650 mg 6th hourly for a period of 3 to 5 days, as the symptoms die out by 5 days.

3. Your wife should drink plenty of fluids, I would suggest drinking fresh fruit juices and eating adequate amounts of foods during convalescence to build back the energy.

4. She would also need to take adequate rest, 1 week of bed rest is what I advice.

5. typhoid is generally transmitted by feco-oral route, meaning, the bacteria are transmitted from the hands of contaminated person who might be a carrier to other person through foods and water. So you should take care when you eat out and you should always drink boiled water or chlorinated water.

So, as of now, I would suggest, a complete hemogram, blood culture and sensitivity (which should include all the medicines I have listed earlier), and a repeat WIDAL after 5 days to 1 week after the first WIDAL.

Consult your local doctor for the prescription of medicines as appropriate.

I hope I have answered your question adequately. Please do write back if you have any doubts or further concerns.

Wishing your wife a speedy recovery.

Warm regards,
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