Brief Answer:
Try further tests and antibiotic change
Detailed Answer:
A large number of questions I asked remain unanswered.
Widal is not a very good test for typhoid detection, unless it is very strongly positive. I would request you to let me know the titres, or simply upload the report.
Personally, I would have suggested a blood and urine culture in a patient I was treating, to make sure that there was no other infection going on. An
ultrasound of the abdomen would have been useful in view of your ongoing
stomach discomfort. An X ray would have also helped.
Now
Azithral is not a very good medicine for typhoid. It was a very good medicine a few years ago, but recently the bacteria has grown stronger.
I would have suggested intravenous antibiotics to my patient if 9-10 days had lapsed. Alternatively, you can talk to your doctor about changing antibiotics to
fluoroquinolones, or second generation cephalosporins. Personally injectibles would be my personal choice.
Please do repeat a
complete blood count, and malarial antigen and fasting blood sugar.
Hope to hear from you soon with further queries
Dr Saumya Mittal
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports.
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