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Is Meftal And Crocin The Right Medicines For Fever?
Question: Hi Doctor, My son is 3 year old with 11 Kg weight. On 13th September morning we found that he is having fever in the range of 101-102 deg F. We have given him 6 ml Crocin (120mg/5ml) & then met with our pediatrician in the afternoon. Our Dr. suggested that we should continue with Crocin & Meftal (3ml if needed) for 3-4 days. 13 & 14th Sept, we were required to give crocin every after 6 hours & meftal also twice in a day (when crocin could not bring the fever below 100 deg F). On 15th whole day fever did not come but on 16th Morning again fever came (100-101 deg F) & we were required to give Crocin 3 times. My son was also having coughing & blocked nose during this period. 17th we revisited (Fever 100-101 deg F) the Dr. & he said to start Tixylix syp (thrice a day - 5 ml) for coughing. On 17th evening my son was having heavy coughing so Dr. suggested over phone to start 3 ml Zifi 100, twice a day. On 18th ( No fever) evening my son was crying for not taking medicine & during the same he vomited (fever 100 deg F). We again visited the Dr. & from physical examination & tongue scaling he guessed that it might be Typhoid, he suggested to increase dose of Zifi 100 from 3 ml to 5 ml, twice daily & Lanzol Jr. 15 mg once a day & also suggested for following testing; CBC (HB/TLC/PCV/RBC/Platelet), Malaria Antigen, SGOT, SGPT, Blood C & S, Dengue Serology, Widal Test, C-Reactive Proteins (CRP), Malarial Parasite, Typhoid IGM, Dengue NS1 Antigen; we have given blood sample of my son on 18th evening ( 6th day of fever & Zifi 100 started on 5th Day evening). On 19th (No fever) all reports came except Widal & Blood C & S. I will attach all reports if your site permits but explaining main features; Typhoid IgM was positive & SGOT was little high ( 52). My doctor suggested to continue Zifi 100, 5 ml ,twice daily for total 14 days ( excluding intial 2 dose of 3 ml on 17th evening & 18th Morning) & 5 ml zincovit syp. On 20th i received Widal test report & that was negative [ S. Typhi (o) < 1:40; S. Typhi (H) < 1:40; S. Paratyphi (A-H) < 1:40, S. Paratyphi (B-H) <1:40 ], Blood C & S report is still awaited . Since 18th there is no fever but mild coughing still persist. Currently we are giving; Lanjol Jr. (15 mg) once a day, Zifi 100 5ml twice daily, Zincovit Syp. 5 ml once daily & Tixylix 5 ml twice daily. My son looks week & appetite loss is also seen. We are giving small small doses of food including milk, rice, thin dal (moong & masoor), apple, phulka roti & Parantha ( as he cries for it). My concerns are
1) Whether we are on right track?
2) I have read over net that Widal may come Negative if antibiotic is started earlier ( in my case antibiotic started on 17th evening & blood sample given on 18th evning) so Typhoid IgM positive is sufficient to conclude Typhoid or not.
3)Typhoid IgM is a antibiotic presence test in blood. In lay man language i understand that Zifi is Typhoid antibiotic so if some one has already started antibiotic course then how to distinguish that lab results are showing normal body antibiotic or medicinal antibiotic. I mean to say that whether starting Zifi earlier to blood sampling may lead to effect Typhoid IgM result.
4) As per net Blood C & S is supposed to be more conclusive (report is expected by day after tomorrow) but here also the case is same that blood sample is given on 18th evening & antibiotic started on 17th evening so two doses of 3 ml were already consumed. Whether this situation will effects the result?
5 ) My son had received Typhoid vaccine as per prescribed schedule in past, whether this may also effect Typhoid IgM result.
6) How different stages of Typhoids are defined & in which stage our case is?
7) Now its 11th day since beginning& fever was settled on 6th day, antibiotic is continued for last 5 days; i would like to know by what time full recovery is possible as my son seems week by face. Activity was he is 70-80% from earlier. We are monitoring food, water intake as well as urine out take etc. Just wanted to know by what time full recovery is possible. Thanks & regards
1) Whether we are on right track?
2) I have read over net that Widal may come Negative if antibiotic is started earlier ( in my case antibiotic started on 17th evening & blood sample given on 18th evning) so Typhoid IgM positive is sufficient to conclude Typhoid or not.
3)Typhoid IgM is a antibiotic presence test in blood. In lay man language i understand that Zifi is Typhoid antibiotic so if some one has already started antibiotic course then how to distinguish that lab results are showing normal body antibiotic or medicinal antibiotic. I mean to say that whether starting Zifi earlier to blood sampling may lead to effect Typhoid IgM result.
4) As per net Blood C & S is supposed to be more conclusive (report is expected by day after tomorrow) but here also the case is same that blood sample is given on 18th evening & antibiotic started on 17th evening so two doses of 3 ml were already consumed. Whether this situation will effects the result?
5 ) My son had received Typhoid vaccine as per prescribed schedule in past, whether this may also effect Typhoid IgM result.
6) How different stages of Typhoids are defined & in which stage our case is?
7) Now its 11th day since beginning& fever was settled on 6th day, antibiotic is continued for last 5 days; i would like to know by what time full recovery is possible as my son seems week by face. Activity was he is 70-80% from earlier. We are monitoring food, water intake as well as urine out take etc. Just wanted to know by what time full recovery is possible. Thanks & regards
Brief Answer:
On right track.
Detailed Answer:
Hi,
Thanks for writing to us.
1. Yes, you are on right track. You are giving proper antibiotics and fever has settled. So treatment is effective.
2. Widal is not reliable at all. No need to bother about the result
3. Zifi has no interaction with IgM .
4. Blood culture may be affected by one or two doses. If positive it will confirm. Even if it is negative, the diagnosis is still typhoid because the IgM test is positive.
5. Vaccines only cause IgG not IgM.
6. I think your child is in recovery stage. There are no defined stages though.
7. It may take 2 to 4 weeks for complete recovery.
Ensure you avoid spicy oily foods.
Wishing good health
Regards
Dr Arun
On right track.
Detailed Answer:
Hi,
Thanks for writing to us.
1. Yes, you are on right track. You are giving proper antibiotics and fever has settled. So treatment is effective.
2. Widal is not reliable at all. No need to bother about the result
3. Zifi has no interaction with IgM .
4. Blood culture may be affected by one or two doses. If positive it will confirm. Even if it is negative, the diagnosis is still typhoid because the IgM test is positive.
5. Vaccines only cause IgG not IgM.
6. I think your child is in recovery stage. There are no defined stages though.
7. It may take 2 to 4 weeks for complete recovery.
Ensure you avoid spicy oily foods.
Wishing good health
Regards
Dr Arun
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
1) Should we continue Lanzol Jr. 15 mg during full course of Zifi (i.e. 14 days) or we can now give Lanzol on alternate days.
2) Once 14 days Zifi course is completed then whether any retesting is required to confirm complete elimination of bacteria.
3) After completion of Zifi course whether my son will be still carrier for some time.
4) How to protect other family members?
2) Once 14 days Zifi course is completed then whether any retesting is required to confirm complete elimination of bacteria.
3) After completion of Zifi course whether my son will be still carrier for some time.
4) How to protect other family members?
Brief Answer:
Lanzol to be given daily.
Detailed Answer:
1. Better to give lanzol daily
2. Repeat blood culture it will be negative if treated fully, other tests will not be helpful.
3. Carrier state is possible in typhoid but if adequately treated, chances are less.
4. Handwashing, boiled water and typhoid vaccination for family members including adults .
Regards
Lanzol to be given daily.
Detailed Answer:
1. Better to give lanzol daily
2. Repeat blood culture it will be negative if treated fully, other tests will not be helpful.
3. Carrier state is possible in typhoid but if adequately treated, chances are less.
4. Handwashing, boiled water and typhoid vaccination for family members including adults .
Regards
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
XXXXXXX RO water (having RO, UF & UV) should be treated as good as boiled or not
What's about bathing & brushing water quality, do we also use RO water for brushing?
What's about bathing & brushing water quality, do we also use RO water for brushing?
Brief Answer:
yes
Detailed Answer:
RO if properly maintained and serviced , is good as boiled water
For Brushing too, better to use RO, bathing you can use normal water, but if he swallows that , then use RO for that too.
yes
Detailed Answer:
RO if properly maintained and serviced , is good as boiled water
For Brushing too, better to use RO, bathing you can use normal water, but if he swallows that , then use RO for that too.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Hi Doctor,
Blood C & S report (sample given on 18th Sept.'14 whereas Zifi was started on 17th evening) is showing no growth in 5 days.
1) what does it mean?
& if it means Negative then
2) is there any sense to repeat the test once Zifi course is completed as suggested by you earlier, again if the answer is No
3) then how to confirm that bacteria is totally eliminated post completion of Zifi course.
Blood C & S report (sample given on 18th Sept.'14 whereas Zifi was started on 17th evening) is showing no growth in 5 days.
1) what does it mean?
& if it means Negative then
2) is there any sense to repeat the test once Zifi course is completed as suggested by you earlier, again if the answer is No
3) then how to confirm that bacteria is totally eliminated post completion of Zifi course.
Brief Answer:
It can be negative
Detailed Answer:
The culture came negative because it was taken on antibiotics.
You need to repeat culture
Repeat culture after 2 days of stopping antibiotics.
There is no other way to confirm except clinical improvement.
Thank you.
It can be negative
Detailed Answer:
The culture came negative because it was taken on antibiotics.
You need to repeat culture
Repeat culture after 2 days of stopping antibiotics.
There is no other way to confirm except clinical improvement.
Thank you.
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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