Hello,
Welcome to Health Care Magic.
Thanks for writing.
I am Dr.Saddiq ul Abidin. I have read you question completely, i understand your concern and will try to help you in best way possible.
The kind of symptoms you have mentioned, makes Relapse of the
Enteric fever aka typhoid, a most probable diagnosis, however it would have been more appreciable if we had known whether or not, any history of altered bowel habits, or any suspicion of a concomitant infection, whether urinary or respiratory exist or not?
It is quite possible to have relapse of Enteric fever, because it is one of those infections which has notoriously high tendency to go into chronic or relapsing patterns. Also that partially treated Enterics, or leaving the antibiotic once fever is settled, increases the likelihood of such incidences.
The most reliable test would have been a
blood culture, even typhidot has also got a lower specificity to the Enteric fever. An associated decrease in WBC count along with some other cell lines in your CBC, can also rise the possibility of typhoid.
Also that, the screening tests like
urinalysis, Chest X-ray and other baselines biochemistry, monitoring your kidney and liver status, to essentially rule out possibility of any other common systemic infection. Here I would also like to suggest, that you may need a repeated LFTs monitoring, as enteric fever has got the tendency to have complications like Enteric hepatitis.
If you were my patient, i would have recommended you tab.
Ciprofloxacin 500 twice daily for 10-14 days, even if the fever subsides, to avoid chronicity of the infection. If no response is achieved in 5-7 days, then addition of
azithromycin 250mg twice daily to the current regimen has shown to increase the efficacy and better clearance rates.
Along with that, use of antipyretics, and motility agents, like
domperidone would have been more comforting.
If god forbid, the infection persists, and there is no other signs or laboratory findings suggestive of any other organ system involvement, based on the history, Indoor treatement with IV
ceftriaxone 2g twice daily would have been the next relevant thing to do, but I hope the things will not go to that extent hopefully. Stay connected to your doctor and keep on seeking regular advice and checkups.
I hope this answered your question.If you have more queries I am happy to answer. Otherwise rate and close the discussion
Regards,
Dr.Saddiq ul Abidin
M.B.B.S(Licensed Family Physician)
Resident Medicine.