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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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High fever. Blood tests, urine culture are normal. Typhoid?

hi, i had fever last 13 days. i had checked with doctor last 7 days ago when my temp counted 104 degree and suspected it is typhoid and do some test Blood Culture, Urine Culture, tripple antigen etc. i started to take Antibiotic (Azithromycin USP 500 mg). when i get the test report after 4 days of visited the doctor, doctor didnt found any major infection and although he didnt found any cause having fever for long time. all are ok. but still i have fever of 102 degree if i didnt take the medicine Paracetamol 665 mg. Can you please advise is it really typhoid or any thing else ?
Wed, 14 Aug 2013
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General & Family Physician 's  Response
Hello Good Evening,

Welcome to HCM,

As you have 13 days fever then, it might be severe blood infection, can be Typhoid or Malaria, should be strictly rule out.

You should be hospitalized now and get evaluated and treatment.

Following investigations should be done:

-Widal (tube) test
-CBC
-ESR
-MP Card test
-RFT
-LFT
-USG whole abdomen

and following treatment should be started:

Inj. Ceftriaxone, Inj. Ofloxacin, IV fluids, symptomatic and supportive treatment, and most importantly anti malarial treatment if clinician suspect it.

Regards,

Dr. Naresh Jain.
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Radiologist Dr. Indu Kumar's  Response
Hello
Thanks for writing to HCM
You need few more investigations.
Widal test for typhoid is done in second week of fever so,it can be done as you have fever for 14 days.
Also malarial parasite test can be done.
Chest X-ray ( PA) and ultrasound of abdomen should also be done to find out any hidden pathology.
Liver function test,RBS should also be done.
Further investigations depends upon clinical findings and investigations report.
Take Care
Dr.Indu Bhushan
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Internal Medicine Specialist Dr. Akhilesh Dubey's  Response
Hi,
Thanks for using Healthcaremagic,
After going through your history, you are having high grade fever for last almost 2 week.
Common causes are viral fever, Malaria and Typhoid but as you have been investigated and nothing came positive to let us know about the cause.
You need to consult a Internal medicine specialist and after careful examination cause is to be investigated by Complete blood count, X ray chest, Ultrasonography of abdomen and urine R&M and Stool R&M. Sometimes abscess forms and difficult to detect like Liver Abscess.
If Therapeutic trial of anti malarial and antibiotics fails to cure then we have to investigate PUO (Pyrexia of unknown origin) where even bone marrow for any Lymphoma or any malignancy needs to be searched.
Other differential includes connective tissue disorder and even drug fever?
Treatment depends on cause once diagnosis is made it can be treated accordingly.
I hope cause of fever is detected and treated soon.
Wish you good health.
Hope this helps
Take care.
Good Luck.
Dr.Akhilesh Dubey M.D.
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High fever. Blood tests, urine culture are normal. Typhoid?

Hello Good Evening, Welcome to HCM, As you have 13 days fever then, it might be severe blood infection, can be Typhoid or Malaria, should be strictly rule out. You should be hospitalized now and get evaluated and treatment. Following investigations should be done: -Widal (tube) test -CBC -ESR -MP Card test -RFT -LFT -USG whole abdomen and following treatment should be started: Inj. Ceftriaxone, Inj. Ofloxacin, IV fluids, symptomatic and supportive treatment, and most importantly anti malarial treatment if clinician suspect it. Regards, Dr. Naresh Jain.