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What causes typhoid?

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Posted on Thu, 27 Nov 2014
Question: I am 30 yr old male from XXXXXXX I had fever for 20 days, then on 13th Oct2014 I am diagnosed as typhoid, S. Typhi 'O' and 'H' = 1:80, Malaria parasite negative. I consumed cefixime+afloxacin tablet for 3 days it gave bit relief from fever but not complete cure. Till this date I was performing my office works. Then I was administrated with ciprofloxacin IV and 5% Dextrose twice a day along with synriam tablet for three days, thermometer reading was normal but i felt feverish inside and uncomfortable. Then they started Afloxacin and 5% Dextrose twice a day, but my blood report on 18th Oct2014 showed a increased level(S. Typhi 'O' = 1:80and 'H' = 1:160), Mountex test negative, X-ray normal. so they continued Afloxacin and 5% Dextrose twice a day. but after afloxacin administration i felt weak, high fever 102+ 'F . Then they started to inject CP vial, paracetamol tonic and tablet in additional to Afloxacin and RL. but high fever persist(100 to 102 F, sometimes normal temperature), my body started producing more heat, i couldnt sleep before that i never had sleeping problem. Then they injected me with alpha beta arteether(four dose). then i was discharged but had fever. Then they prescribed me Camoquine and Trika. After taking this tablet i slept and feel better, but low fever prevails, i am weak and confused. please help me in this regard. what could be the reason for this illness?

Blood Values on 13th Oct2014.
Haemoglobin: 13.8 gms% 86%
Total WBC Count: 6100 cell/ cu. mm
Lymphocytes: 28%
Eosinophils: 4%
Monocytes: 1%
Platelet count: 2.20 Lakhs/cu. mm
Erythrocyte sedimentation rate: 30 Min= 7 mm, 60 Min= 15 mm
Urine test:
Colour: yellow
Reaction: acid
Albumin: Nil
Sugar random: Negative
PUS cells: 2-3 HPF
RBC: nil
Epithelial cells: occasional
doctor
Answered by Dr. Indu Kumar (26 minutes later)
Brief Answer:
You should allow some time for recovery.

Detailed Answer:
Hello XXXX

I have gone through your query in detail.
You should allow some time for recovery.You have received absolutely right treatment.It is usual after typhoid fever.Recovery time varies with patient.You can take vitamin B complex and take nutritious food.

Your blood report was positive for widal test(done for typhoid fever).You have received right medications.I.V medicines are required in selected cases.

Since you had persistent fever even after best medicines of typhoid fever,empirically you was prescribed anti-malaria drugs.

Your urine report is normal.Up to 5 pus cells are normally found in urine.Occasional epithelial cells are also normally seen.
Other blood report findings are normal.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (1 hour later)
I had unprotected sex with my ex girl friend in Feb2013 two times each less than 3 mins. (Then till date I never had sex). I didn't bother much about that. I almost forgot that. Then in Nov2013 i donated blood to someone through a blood bank, my blood transfused to that person. Later I came to know my ex GF had multiple partners. During this period i gained 5 kg weight. Till this illness I never thought about that, but now everything came into my mind and worries/bothers me. Is there possibility for HIV? Because along withe fever I got bitter taste in tongue, it increased when i consumed camoquine. Bitter taste is not getting away. Where can i get tested for HIV? This is my only concern.

Now i am on camoquine medication
Now i suffer from
1. Lower back pain
2. weak/tired
3. Bitter taste in tongue
4. Warm face
5. Rarely slight fever for few minutes in morning or evening
6. Confused and terrified
7. Poor appetite

help in this regard
doctor
Answered by Dr. Indu Kumar (8 hours later)
Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXX

It is important to screen for HIV as you had unprotected sex and your partner had multiple partners.
You can get the HIV test done at any reputed diagnostic centre.
Some of your symptoms like bitter taste,poor concentration etc due to side effects of camoquine and low backache,tiredness,poor appetite etc are due to illness.Symptoms will go away after discontinuing medicines.So,please allow some time for complete recovery,you will be fine.
Symptoms are also aggravated due to anxiety,so you have been prescribed antianxiety medicines also.
HIV test will also reduce your anxiety.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (14 hours later)
Sir as per your advice, I went for a blood test.

My blood test report (25/10/14)
Total WBC count          : 5900 cells/cu
Neutrophills          : 38%
Lymphocytes          : 52%
Eosinophils               : 1%
Monocyte               : 9%
E.S.R
One hour               : 30 mm
Haemoglobin          : 16.7 gms%
Platelet count          : 1.0 lakh/cu
Smear for MP          : Negative
Widal
S.Thyphi “O”          : Reactive (1:320)
S.Thyphi “H”          : Reactive (1:320)

PCV                    : 49.1 %
R.A Factor               : 16
HIV 1+2               : Non-Reactive
Bio-Chemistry     
SR.Creatinine          : 0.7 Mg/DL
SR.Uric acid          : 6.5 Mg/DL
Urine Test
Urine Albumin          : Nil
Sugar                    : Nil
Bile Salt               : Negative
Bile Pigment          : Negative
Deposits/HPF
PUS Cells               : 2-4
RBC,S cells               : Nil
EPI Cells               :0-2


Its shows elevated level of S.Thypi infection and low platelet factor. Except these two I am not able to understand anything. What could be reason for my illness? What is the remedy? Please help me out in this regard. Your valuable advice needed.
doctor
Answered by Dr. Indu Kumar (6 hours later)
Brief Answer:
Typhoid fever

Detailed Answer:
Hello XXXX

Findings confirm typhoid fever.There is increase in titration.Other findings like low neutrophil with increase in lymphocyte and increased ESR are also related to typhoid.This is commonly seen in typhoid fever.
You need observation and follow up for platelet count.
Other findings like urine report is normal.

You should continue your medicines.You will recover soon.HIV test is negative.Don't worry about this.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Indu Kumar (12 days later)
Sir,
On 27th Oct, my platelet count= 2.1 lakhs/cu, WBC=6100 cells/cu, Doctor advised me to stop medication and prescribed me to take tablet Oxigen-G (Antioxidant and L-glutamic acid). I felt good for three days (no fever) but had body pain and bitter mouth. Then on 1stNov, i took bath and went out for shopping (for mental relief) but after sometime my eyes became red and felt feverish.
So next day (2nd Nov) i went to hospital and my temp= 100'F.

Widal test= positive
Body weight=61 kg (was 66kg, i lost 5 kg )

Doctor administrated Ceftriaxone + Tazobactam(IV) for three days(3rd-5thNov), during those three days i had fever (99-100'F). During that period i felt pain/needles/itchy felling in lymph nodes (around chest+ armpit). i told doctor that, i feel pain in chest muscles, He said it’s ok. Don’t worry too much. On 6th Nov, Doctor advised me to stop medication and asked me to see him if i get fever again.

On 5th Nov body weight= 63 kg

Now for two days, i am not taking any medication, temp (98-99'F),
Slight body pain, but bitter mouth,ulcers in gum, slight pain/needles/itchy felling around chest muscles/armpit(is it lymph nodes?).

My concern is
1. it’s been more than a month, i am not completely relived from illness,
2. i am worried about bitter mouth/gum ulcer and pain in armpit and chest muscles, body pain and weakness.
3. What could be reason for my illness?
4. I am worried about HIV also; Sir, Does any of my symptoms looks like related to HIV? i know i am too much worried/anxious, the problem is in my mind. i couldn't be peaceful. I think, I should stop reading things in internet.

Sir, I need your valuable advice and counseling.
Make me understand that i am not seriously sick (especially HIV).
Please help me to overcome this problem.


doctor
Answered by Dr. Indu Kumar (6 hours later)
Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXX

You are slowly recovering from your illness.In some patients, recovery time varies. This is natural.

Bitter mouth/gum ulcer is related to medicines that you have taken. Prolong medication causes destruction of normal flora. You can take vitamin B complex tablets once daily. You are rightly prescribed antioxidants.

Don't worry about HIV. It must had been positive if you are suffering from this disease. Window period is crossed for HIV, so HIV test should be positive if you have had it. Don't worry, you will be fine soon.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6727 Questions

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What causes typhoid?

Brief Answer: You should allow some time for recovery. Detailed Answer: Hello XXXX I have gone through your query in detail. You should allow some time for recovery.You have received absolutely right treatment.It is usual after typhoid fever.Recovery time varies with patient.You can take vitamin B complex and take nutritious food. Your blood report was positive for widal test(done for typhoid fever).You have received right medications.I.V medicines are required in selected cases. Since you had persistent fever even after best medicines of typhoid fever,empirically you was prescribed anti-malaria drugs. Your urine report is normal.Up to 5 pus cells are normally found in urine.Occasional epithelial cells are also normally seen. Other blood report findings are normal. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX