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Recurrent typhoid, took treatments, still S-t and P-t in Widal are always high, non-conclusive. Solution ?

My wife was diagnosed for having typhoid in feb-2012. In Widal, both the S-tyhhae and P-typhae were in the proportion 1:160. She was given Azithromycin with other antibiotic for 10 days. the count reduced to 1:40 in both cases. Doctor suggested to continue the medication for another 5 days and no need to test further. Again after 3 months she felt some mild fever and on pathological investigation, her S-t and P-t found to be 1:160 and 1:80 respectively. Again she was given the same medicine. During dec-12 same thing happened. This feb-13 as again she felt feverish for 7 days we went for test and the result is same (S-t and P-t -1:160 and 1:80 resp.) The doctor suggested that no need to go for tests as such positive report comes in all cases and Widal is not conclusive. As she was having some cold the physician prescribed anti allergic with antibiotic vig. cefixime and azithro combination. The symptom she only feels feverish, mild mostly in night. No vomitting, no pain in the abdomen . Kindly advise.
Asked On : Wed, 6 Mar 2013
Answers:  2 Views:  46
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Pediatrician 's  Response
Feb 2013
Thank you for your query,
In typhiod fever, the widal test detects antibodies and the antibodies will persist longer even though infection is treated with appropriate antibiotic for proper duration.
But relapses are also common in typhoid fever due to the resistance of slamonella to drugs.
You continue the medication as advised by your doctor and take vaccination for typhoid after consulting him.
Hope I have answered your query.
Answered: Thu, 7 Mar 2013
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Pediatrician Dr. Himanshi Kashyap's  Response
Widal test is not a specific test for typhoid and the titre remain high even after the infection has got corrected for many months.Recurrence of typhoid is known so best is to do Blood Culture for diagnosing this time.Anyways hope this time the fever is due to viral infection.In addition I would advise you to get your wife vaccinated against typhoid which will give her immunity against this infection for 3years when she is off fever.

Take care.
Answered: Wed, 6 Mar 2013
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