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Having mild weakness. Blood test positive for typhoid. Taking Sparfloxacin. Having fever in evening. Normal in typhoid?

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Infectious Diseases Specialist
Practicing since : 2000
Answered : 180 Questions
I was having mild weakness (not fever) since last wednesday (20th june), but on this monday(24th june), in the afternoon i really felt weak and got my blood tested for Dengue and Typhoid(TYPHI DOT IgM=Positive), and found positive for typhoid, since 3 days i taking Sparfloxacin 200mg, twice a day(morning and night) together with Hifenac(twice a day).
I am not feeling any body pains,tiredness etc, ONLY IN THE EVENING ( yesterday and today) my temperature was around 99.-99.6 F. How long it may take for me to recover.. is this on and off temperature is normal with typhoid?
I am taking 2 tender coconuts juice, orange juice ,multivitamin syrup everyday.
Posted Thu, 18 Jul 2013 in Infections
Answered by Dr. Binod Kumar Pati 55 minutes later
Thanks for using XXXXXXX for your question.
Oh yes , you are in right direction.
Off and on fever, while on therapy for the first few days is commonly seen in typhoid patients. The fever usually starts to defervesce in 2-3 days and takes around 10 days to 2 weeks for complete resolution.

Regarding diet : take what ever you feel like. Take plenty of water in addition.
All the best.
Above answer was peer-reviewed by
Follow-up: Having mild weakness. Blood test positive for typhoid. Taking Sparfloxacin. Having fever in evening. Normal in typhoid? 47 hours later
Hello Dr
Thanks for the answer.
Today, since my consulting doctor was out of the station and today was end of 5th day of my antibiotic therapy,i consulted another XXXXXXX medicine specialist, he was of the opinion its very difficult to confirm typhoid with just TYPHI DOT test and since the starting ,my body temperature at XXXXXXX was 99.6F , so he asked me to go to WIDEL test and he also suggested the liver function test as weakness can be from other reasons also.

He asked me to stop SPARFLOXACIN and Hifenac, as prescribed me ZANOCIN DS (0-1-0)X5 and IBUGESIC PLUS (1-1-1)X3 and SOMPRAZ D40 (1-0-1)X5 days.

Presently, except mild weakness,No Diarrhea, no vomitting , no headache etc i feel i have recovered a bit , but even now my temperatures will be around 98.7-99.3 F and also i have lost 2 kgs.. Is my treatment is going in right direction and what might be reason behind changing the medicines.

Answered by Dr. Binod Kumar Pati 5 hours later
I do respect the opinion of you consulting doctor. It is actually difficult to diagnose typhoid. Even a single widal cannot give you conclusive diagnosis. It is particularly true in endemic country like India. The gold standard for diagnosis is culture isolation of the organism from blood. It has an extra advantage of putting up susceptibility against different antimicrobials, which is suppose to guide in selection of antibiotics.
For empiric therapy fluoroquinolone group of drugs are preffered. Many Indian guidelines recommend Cefixime, Ciprofloxacin or Ofloxacin as the preffered agents. That is the reason probably why it is changed.
Ibugesic is antipyretics and sompraz is given to combat the gastritis.

Hope things are clear now.
Have a very nice day
Above answer was peer-reviewed by
Follow-up: Having mild weakness. Blood test positive for typhoid. Taking Sparfloxacin. Having fever in evening. Normal in typhoid? 17 hours later
Hello Dr
Thanks for the reply.
My widel test reports have come
Salmonella typhi 0 = Less than 1;20
Salmonella typhi H = Less than 1;20
Salmonella typhi A0 = Less than 1;20
Salmonella typhi AH = Less than 1;20
Salmonella typhi B0 = Less than 1;20
Salmonella typhi BH = Less than 1;20
Widel Test =Negative,

Liver function test report.

Gamma Glutamyl :24 (Range 1-55)
Total protein:802(6.3-8.3)
Total Bilirubin:0.6(0.1-1.2)
Direct Bilirubin:0.1(0-0.3)
Alk phosphate:71(40-139)

Hb: 16.5 (13-17)
Packed Cell volume:48.6(40-50)
Red blood Cells:5.5(4.5-5.5)
WBC:7400 (4000-0000)

Differential Count:
Neutrophil: 52%(40-75)
Platelet count:0000(0000-0000)

Please give your opinion Doctor,do you think i still have TYPHOID or its a case of HEPATITIS?

Answered by Dr. Binod Kumar Pati 29 hours later

This widal is negative. But as I have told you earlier, it is difficult to say it to be typhoid unless and until we repeat a widal after 2 weeks and demonstrate a 4 fold rise in antibody titer.

I cannot even give you a conclusion about hepatitis with these much investigations.
More over the rise of liver enzymes are not very much significant.

My advice at this time will be to revisit your consultant with the investigation reports. Many a time such features turn out to be due to a viral illness.

Hope, I am clear.

You can close the discussion and rate it, if there is no more to ask.

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