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Having high fever, immense body pain. Had widal test. Should I be worried about the findings?

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Practicing since : 2006
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My mother is 72 years old, she is running with high fever from last three days. Widal test done after three days of fever. Reports are s typhi-o 1:80,S.typhi-h 1:160, S.para typhi Ah 1:320, s.para typhi Bh 1:80. Pls advice whether is it typhoid. She is gone too weak and also having immense body pain and slight swelling on face and hand. Pls advise the line of treatment.
Posted Thu, 21 Nov 2013 in Infections
Answered by Dr. Basheer Ahamed 1 hour later
Brief Answer: Single Widal test may not be significant. Detailed Answer: Hello, With a medical history of diabetes your mother is more prone for bacterial infections. In Widal test SO more then 1:160 indicates active infection and SH more then 1:160 indicates past infection. Secondly with three days of fever single Widal test is not significant. Your mother needs a Serial Widal test(Follow up) after a week. If there is a four fold increase in the titres it is confirmatory for typhoid infection. If I were the treating doctor I would first hospitalize your mother I will try to Control of body temperature with Tepid sponging and Paracetamol. Same time order Blood culture and Specific blood tests like IgG and IgM for typhoid that helps me diagnose immediately and choose right antibiotic. Monitoring of Platelets is also essential at this stage. If the Platelets decrease below 50,000 then it will be very critical and prone for bleeding. Fresh frozen plasma transfusion for increase of platelet. We can start I.V antibiotics like Cephalosporins for 2 weeks. Fluid management. At the same Control of blood sugar is important. Hope the answer helps you. Let me know if there is any clarifications. Regards.
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