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Mild fever, lose stools, palpitation, weakness following typhoid. On antibiotics, thyronom. Is it normal?

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General & Family Physician
Practicing since : 2010
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Hello Doctor,

I'm female, 37 years of age, currently recuperating from typhoid.
Here is my case: From the last week of January, I had these symptoms: watery stools (once a day) and mild fever. Doctors suspected a stomach bug but as the symptoms did not disappear after a course of antibiotics I was asked to undergo some tests.

I tested positive for typhoid on February 28, 2013 (1:80, S Typhi`O' and 1:80, S Tyhi `H'). My blood pressure was 90/60 and temperature about 99 F. This time the antibiotics prescribed was one O2 tablet(Ofloxacin, Ornidazole), twice a day. I was asked to discontinue O2 after ten days. Thereafter for about a week, I was asked only take a tablet (Rantac for acidity) and another (Immugut)for good bacteria. Throughout the treatment I was asked to drink ORS, fluids etc, which I did. But I had mild temperature and continued to pass watery stools about 3-4 times a day till the last week of March. A test done on April 4, showed a S typhi count of 1:40.

It has been more than a month since I tested positive for typhoid and about a month since I stopped the antibiotics, but I cannot resume work because of weakness (legs tremble, palpitations after slight activity).

My blood pressure continues to be in the range of 90/60. Before I was diagnosed with typhoid, I had a tendency towards a slightly lower blood pressure (100/70) and it was attributed to my medication for hypothyroid condition. I take 100 mcg Thyronom every morning (tests done in Feb, 2013: T3: 170. T4, 10.2. TSH: 1.2).

The doctor (a GP) says I only had a mild form of typhoid and the weakness is probably because of low blood pressure which is probably caused by my thyroid medication.

I wanted to know if it is common for typhoid patients to feel weak for so long. Should I visit a gastroenterologist or an endocrinologist or both? Is it possible that the low BP points to XXXXXXX other problem?

Please give me your opinion.

Posted Fri, 3 May 2013 in General Health
Answered by Dr. Muhammad Ishfaq Habib 43 minutes later
Welcome to XXXXXXX

Thanks for providing such detailed history

The test you have performed for typhoid is a non-reliable test and no more recommended these days however the values you have received suggests weak positive typhoid which cannot be commented. The more reliable and specific test for typhoid is Typhi.DOT which detect IgM antibodies in acute infection and IgG antibodies for chronic infection. Therefore you should go for that test.

The typhoid is an intestinal infection that causes fever which continuous and often high grade and generalized body aches and weakness. stomach pain may also occurs and may or may not be accompanied with nausea or vomiting however it rarely causes watery diarrhea. It may be possible that you might be having gastroenteritis along with typhoid which we call supradded infection.

The salmonella species which causes typhoid have developed resistance to quinolones group of drugs which includes ofloxacin, ciprofloxacin and levofloxacin etc. The antibiotic indicated now a days for typhoid is ceftriaxone or cefexime which is third generation cephalosporins and covers both typhoid and gastroenteritis.

The low blood pressure issues is most probably due to the loss of fluid and electrolytes during diarrhea which takes time to restore however you have been experiencing the problems for much longer times you can use multivitamin along with dispersable Calcium tablets. The hypothyroidism do cause fatigue and weakness but it can be controlled by controlling the thyroid levels.

I would recommend to have Typhi.DOT and if its positive then got it treated first then visit endocrinologist for adjustment of the dose to control you thyroid hormone levels.

If you still have some query, feel free to ask

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