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Dr. Andrew Rynne

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Suffering from fever, increase in temperature, have typhoid fever, low platelet count, high WBC count. Done CBC. Explain

Hi, my daughter is suffering from fever from the past 6 days, like temperature goes around 100 in night and by morning it comes down. Consulted the doctor and got her CBC done.. Her reports are like WBC is in 3530/cu.mm, RBC 4.3, HB 11.1, Haematocrit(pcv) 33.7% and platelet count is 0000/cu.mm, and in differential count Neutrophils are 30.6% and rest in normal range. I was told that she is having enteric fever, Is enteric and typhoid fever same.But in internet i came to know that in typhoid fever platelet count will be low andwbc count will be high, Please clarify.
Thu, 4 Jul 2013
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Pediatrician 's  Response
hi
thanks for your query
i can feel your concerns

yes enteric and typhoid are exchangable terms and are same.
in typhoid WBC count is usually seen on lower side as in case of your daughter and it is not necessary for platelets to be low.they can be normal as well.
Nowadays more specific tests for typhoid are also available like Widal AND ELISA.U can have these tests after consulting your doctor
wishing her a speedy recovery
i am available for your help
regards
dr.imran
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General & Family Physician Dr. Mushtaque Mastim's  Response
Dear XXXXX

Enteric fever includes both typhoid fever (caused by Salmonella typhi) as well as paratyphoid fever (caused by Salmonella paratyphi A, B and C). In practice it is usually interchangeably with typhoid fever as paratyphoid infections are less common, less severe and difficult to differentiate from typhoid.

In typhoid fever usually the laboratory results show following:
•     Thrombocytopenia (Low platelet count)
•     Leucopenia (Low WBC count) with Lymphocytosis (High Lymphocytes count)

Best serological test to confirm typhoid is called the Widal test which gets positive only after 5 to 7 days of fever.

Kindly note usual clinical presentation of typhoid fever is as follows:
•     Typical step –ladder pattern fever (i.e gradual rise in first week)
•     Headache, bodyache, anorexia, myalgia may also be present
•     Abdominal pain
•     Dry and coated tongue
•     Rashs on trunk after 7 to 10 days.

Hope that answers your query

Wish your daughter faster recovery

With Best Regards

Dr Mushtaque
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General & Family Physician Dr. Chirag Soni's  Response
Welcome to HCM.
Wbc count is low and fever for 6 days suggest typhoid fever but platelet count in not always low in this fever.
Most of typhoid fever cases show low wbc count.
After 6th day of fever go for S.widal test to confirm the diagnosis and start treatment accordingly.
Oral antibiotic like ofloxacin,cefixime is helpful in this condition.
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