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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Fever, Loose Yellow Stools, Vomiting, Abdominal Pain. Done Cholecystectomy, Appendectomy. Mono Spot Positive?

i am 21 years female. Have spikes of fever up to 39.5 c. associated with Loose yellow stools, vomiting, abdominal pain since 9 days after eating food out side. I have cholecystectomy & appendectomy done many years back. No other past medical history.. No leukocytosis, Wedal Test negative but Blood culture came Salmonella Typhi and Mono Spot test is positive. AST 210 u/L, ALT 247 ALKP 258 HB dropped from 11.6 to 8,4 gm/dl. First took empirically CIPROFLOXACIN but no response. Lattea,As per culture blood sensitivity, took Ceftriaxone 1 GM I/V for 4 days but no response in fever. Now antibiotic has changed to second drug I/V Augmentin as per blood culture sensitivity report. My question is with Salmonella Typhi, Mono Spot can be positive? And what shall i do next? Now i do not have abd pain nor vomiting but still have high spikes of fever 39c, no joint pains, no skin rash, no headache, no dyspnea etc.
Tue, 30 Jul 2013
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General Surgeon,  's  Response
Hi ! The liver function test can be upset both in enteric fever and in infectious mononeucleosis with positive mono spot test. However, with a history of eating outside and bowel disorders, and blood culture report it goes more in favour of enteric fever. In case of infectious mononeucleosis, there is no specific treatment as such excepting for symptomatic treatment. I would suggest you to go for a repeat monospot test along with some special tests for infectious monocleosis if suspected strongly by your treating physician. Any type of chronic fever (high grade) will cause anaemia and this can occur in Enteric fever. You can go again for a culture sensitivity after consulting your physician, and a peripheral smear to look for malarial parasite, and any abnormal cells. After all these repeat test, your treating physician can re examine you, and decide on further course of action. wishing you a complete recovery.
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Have Fever, Loose Yellow Stools, Vomiting, Abdominal Pain. Done Cholecystectomy, Appendectomy. Mono Spot Positive?

Hi ! The liver function test can be upset both in enteric fever and in infectious mononeucleosis with positive mono spot test. However, with a history of eating outside and bowel disorders, and blood culture report it goes more in favour of enteric fever. In case of infectious mononeucleosis, there is no specific treatment as such excepting for symptomatic treatment. I would suggest you to go for a repeat monospot test along with some special tests for infectious monocleosis if suspected strongly by your treating physician. Any type of chronic fever (high grade) will cause anaemia and this can occur in Enteric fever. You can go again for a culture sensitivity after consulting your physician, and a peripheral smear to look for malarial parasite, and any abnormal cells. After all these repeat test, your treating physician can re examine you, and decide on further course of action. wishing you a complete recovery.