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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Prescribed Ceftriaxone For Fever. Done Blood Test. Positive Widal Test. What Is Your Advice?

hi, my dad is having fever around 102F for about 5 days. we saw a GP who prescribed the following medicines: Ceftriaxone injection IP -500mg(later increased to 1g),fepnal-650,oflomac 200,Izra *D 40,Meftal-250. Along with the above medicines he adviced for the the tests which we got done subsequently. The tests and the results are as follows: Erythocytes: 3.8mill/cmm Leucocytes: 6.600cmm Platelets: 1.24 mill/cmm Haemoglobin Percent: 11.1gms/75% ESR: 1st Hour: 15mm Haematocrit(PCV).......31.3% MCV...81.4% MCH.28.4% MCHC.......35.4% Rapid Card Test For: Total parahit PF|PV: Negative Dengue NS1ng/Igm: Negative Windal s Sagglutinationg Reaction: Positive with the above medication being followed strictly for past five days, still the fever keeps on coming at erratic intervals, sometimes after a gap of 15-20 hours, and sometimes more frequently, and fever hovering around 101F.The GP is continuing with the above medication but we aren t seeing any visible solution. What s your advice on this situation. I yearn for valuable suggestion.
Thu, 7 Nov 2013
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Infectious Diseases Specialist,  's  Response
I think with a positive widal test you should be very careful & take complete bed rest for a month or so,as typhoid fever is known for complications. It is better to get A BLOOD CULTURE done, that would detect the pathogen in the blood.without which possibility of ceftriaxone resistant salmonella cannot be ruled out.Get a serum C-reactive protein done to know the inflammation & later for prognosis of infection.i suggest you get a blood culture done preferably blood sample collected just before the febrile status & also just before the next antibiotic dose.Always keep a regular follow up with your clinician & inform about all changes.
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Prescribed Ceftriaxone For Fever. Done Blood Test. Positive Widal Test. What Is Your Advice?

I think with a positive widal test you should be very careful & take complete bed rest for a month or so,as typhoid fever is known for complications. It is better to get A BLOOD CULTURE done, that would detect the pathogen in the blood.without which possibility of ceftriaxone resistant salmonella cannot be ruled out.Get a serum C-reactive protein done to know the inflammation & later for prognosis of infection.i suggest you get a blood culture done preferably blood sample collected just before the febrile status & also just before the next antibiotic dose.Always keep a regular follow up with your clinician & inform about all changes.