How can recurrent typhoid fever be treated despite taking IV antibiotics?
If fever is persisting, then need to investigate further.
I've reviewed all the attached reports. Well, first of all, I couldn't find any reports of Typhoid here. As per these reports of Feb-March'18, no clear diagnosis can be made.
It's good that Dengue, leptospira was already ruled out. However, the CT finding is likely suggestive of some infectious pathology (can be a consequence of the previously diagnosed typhoid fever).
However, if there's just a single spike of fever, no need to worry, just give a single dose of PARACETAMOL 650mg after some food and observe.
However, if fever persists beyond this, then I'd advise you to report to his doctors immediately as there can be a secondary infection (after prolonged hospitalization, the body's immune response become lowered, and can catch a secondary infection).
I hope there's no I.V. line remaining still (if there's any make sure there's no redness/swelling around).
It can due to several other reasons (starting from the respiratory tract to abdominal, urinary tract or even blood borne).
To determine, some basic testing may also be done (only if the fever's persisting) eg. a repeat CBC with peripheral blood smear, Dual antigen for malaria, a fresh urine routine microscopy and culture (blood culture may also need to be repeated, to be decided by his doctor after the clinical check-up).
Is there any other complaint along with fever? Any pain abdomen/ nausea/ vomiting/ loose motion? Do check his body for any kind of skin-rashes also.
Hope I have answered your query. Let me know if I can assist you further.
Please follow as already advised earlier.
I couldn't find any new attachments, all of these were already reviewed. Perhaps remove some of the old ones and reattach the new ones.
Yes, things can be certainly confusing.
However, the next steps will remain the same as already explained earlier i.e. further extensive investigations, as well as serial check-ups, need to be done by his doctor/s (comprehensive involvement by Internal medicine, as well as Infectious disease specialist, should be sought) in order to get the diagnosis at first.
Things can proceed accordingly from there.
Hope I have answered your query.
Dr Arnab Banerjee, Critical Care Specialist
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