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Suffering from on and off fever. Tested negative for malaria parasite. What could be the problem?

Sep 2012
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Answered by

General & Family Physician
Practicing since : 2008
Answered : 1416 Questions
I suffering from fever which is something like coming on on & off basis from last 5 days. My doc here in local gave me these medicines for the time being
1. cap Colosafe DSR (3days)
2. LCZ Tab (3 days)
3. pyrigesic -650 (3 days)
4. Bevon Cap (3 days)
i have gone through this 3 days course but fever is still there. it increseas at night upto 102-103 F.
i have got some tests done wherein the results was like this:-
1. Dengue NS1 ANTIGEN ELISA (serology = 1.06)
2. Rapid Typhi IGM (Not Detected)
3. CBC
a.) Hb = 15.2g/dL
b.) RBC = 5.33 millions/
c.) PCV = 46.9 %
d.) MCV = 88.0fL
e.) MCH = 28.5 pg
f.) MCHC = 32.4gm/dL
g.) RDW = 13.7 %
h.) TLC = 9.1 X10^3/uL
4. DLC
a.) Neutrophills = 75%
b.) Lymphocytes = 20%
c.) Eosinophills = 03%
d.) Monocytes = 02%
e.) Basophils = 00%
5. Platelet Count = 152 x10^3/uL
Smear Examination for Malarial Parasite = NOT DETECTED.

please confirm what could be the problem if everything is alright.

Posted Fri, 16 Nov 2012 in General Health
Answered by Dr. Das Arindam 3 hours later
Firstly, your on and off fever indicates an infection which may be viral or bacterial in nature.
Now, Reports :
- The Dengue NS1 antigen is negative.
- Rapid typhi IgM is negative which excludes a possibility of typhoid fever.
- Complete hemogram indicates hemoglobin, PCV, MCV, RBC, MCH,MCHC, RDW all are at very good level.
- Total leucocyte count is within normal limit.
- But differential count indicates higher neutrophil count, with a lower normal lymphocyte and normal eosinophil count and normal platelet count.

So, overall, it indicates an ongoing bacterial infection which is acute in onset.

You have to do the following
1. Continue the Pyrigesic 650 when you have fever.
2. Take a pantoprazole group of drug once daily before breakfast.
3. Continue the Bevon capsule once daily.
4. Take one broad spectrum antibiotic ( like fluoroquinolones / Amoxicillin group ) after consulting with your treating doctor.
5. Do a blood culture, if the fever does not responds within 7 days.
6. Take nutritious diet and adequate amount of water.

Summary : You have an acute bacterial infection. Consult with your treating doctor for dosing and frequency of medicines mentioned above.

Hope this information suffices. Let me know if you have any more question.

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