What does my blood test report indicate?

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Posted on Fri, 19 Jun 2015 in Infections
Question: Dear Sir,
Good afternoon. I had Typhoid fever 2 weeks before. My blood test result was showing positive for TH (1:50 diln) & TO (1:100 diln). I have used Cefixime-200 & Ofloxacin-200 for 10 days and blood tested after 10 days. Blood test results are TH (1:25) Negative and TO (1:50) Positive. My doctor has adviced me to continue the medication for 4 more days (Totally 10+4 days). AH & BH have been Negative all through. Some pink colored spots are observed on my chest, arm pits and upper shoulder.
Sir, I would like to know whether I am under right medication and how long I should continue this medication. All other blood test parameters are normal. When should I go for next blood test?
How long it will take to completely clear the infection from the blood stream & intestines? I am having light symptoms of motions always from the onset of this problem (for almost one month) stools are hard only. I maintain my hygeine conditions properly. I am using Bifilac for clearing the loose motions problem for more than 2 weeks.
Sir, one important thing I would like to inform that while passing stools, I use my fingers to clear the stools from inside. This has been a practice for almost a year. Whether this practise is OK. Whether it has any effect on piles and could be the reason for the present typhoid condition. I clean my hands with handwash almost 2-3 times after passing stools.
Sir, it would be of great help from you to know my condition and maintain my health properly and also request you to suggest any further tests to be done like stool culture/ blood tests, etc. Is there any chances of other infections which may be reflecting as Typhoid. Kindly suggest.

Sir, kindly go through the previous history/ records uploaded during the last visit with you recently.

Thanks for your patient reading.

With warm regards,
XXXX
doctor
Answered by Dr. Tushar Kanti Biswas 28 minutes later
Brief Answer:
Treatment would suffice

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Your diagnosis of typhoid fever seems to be based on serological test alone. However you developed XXXXXXX spots (some pink colored spots observed on chest, arm pits and upper shoulder) also, which goes in favor of typhoid fever.

Cefixime, 400 mg bid (PO ) for 7–14 days or ofloxacin, 400 mg bid (PO) for 2–5 days is the standard antibiotic therapy for Enteric Fever in Adults.You have been given a combination of Cefixime and ofloxacin (frequency has not been mentioned)for total period of 14 days. That probably would suffice.
At this stage (after taking course of antibiotics) any other test like stool or blood culture will not come positive.
Only about 1–5% of patients who develop chronic carriage of Salmonella can be treated for 4–6 weeks with an appropriate oral antibiotic.

Practice of digital evacuation of stool on regular basis is not considered hygienic as you may not be able to clear adequately fecal materials under the nails and there will always be possibility of feco-oral transmission of infection. Instead take high fiber diet,adequate water orally and if required occasional laxatives ,to avoid hard stools.
Serological tests for typhoid (widal test) will remain positive for a variable length of time after recovery.
Widal test may be false positive (due to antigenic similarity with other pathogens).



Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Tushar Kanti Biswas 44 hours later
Dear sir,
Thank you very much for your kind reply. I have completed my course for 14 days of the medicines (Cefixime-200mg + Ofloxacin-200 mg) one dose in morning and one dose at night after meals (total 28 doses). Sir, I hope I am not overdosed with this frequency.
Presently I have some loose motions (solid motions) 3 times in a day and slight temperature (99.5 oF some times only), which were the starting symptoms of my sickness along with fever 30 days before.
I have light weakness with some body pains also.
Kindly suggest the diet to follow. I am a pure vegetarian.
I was taking only Idlis, Bread and Curd rice, Amway Nutrilite, Tender coconut water and fruit juices during the treatment for around 20 days without use of any spices and oils. Can I start regular food from now onwards.
When should I go for next blood test?
Sir, whether digital evacuation will have any effect on piles? I will start using laxatives as suggested by you.

Kindly suggest me.

Thanking you,
With best regards,
XXXX
doctor
Answered by Dr. Tushar Kanti Biswas 2 hours later
Brief Answer:
Typhoid fever convalescent stage

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Your frequency of motion is normal and also consistency is solid.
Slight rise of temperature is of course unexpected after the completion of course of antibiotic as you mentioned.Up to 10% of patients develop mild relapse, usually within 2–3 weeks of fever resolution and in association with the same strain type and susceptibility profile and usually responds to same course of antibiotic.
You need to continue vegetarian diet as you have mentioned during the convalescent stage.
You can your repeat your complete blood count as in 15–25% of cases, leukopenia and neutropenia are detected.
Digital evacuation can damage anal mucosa if you have not paired your nail.Only with gloves manual evacuation is undertaken medically with adequate lubrication.





Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1909 Questions

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