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Treatment for typhoid and jaundice done, persisting fever. Widal and total bilrubin reports normal. Cause?

Hello my name s tushar age 24yrs i have been sufferin from typhoid nd jaundice at d same time for past 1month according to doctor im cured but still i get fever of 99 in the evenin my last report which was taken a week back showed 1.2 total biliribium nd widal report showed sal typ-o 1:80 typhi-h 1:80 typhi ah1:40 typhi bh 1:40 repectively so my question s wat should i eat.why im gettin fever now.and wen my bed rest will be over ???
Asked On : Thu, 4 Apr 2013
Answers:  3 Views:  634
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Internal Medicine Specialist 's  Response
Welcome to HCM,
After going through your history it is not clear if you had Typhoid and Viral hepatitis because serum bilirubin may be high in both condition but even it was clinically Typhoid then 1 month is long duration.
You have not mentioned details about viral markers or Ultrasonography which confirms Hepatitis as jaundice is only symptom of many diseases.
Your widal titre which is 1:80 and 1:40 is insignificant.
If you have finished antibiotic course of more than 15 days, and your liver function have returned to normal.
Please take normal diet and there is no need to take bed rest just take multivitamin and symptomatic treatment as advised by your Physician.
You may be having weakness due to inadequate diet and prolonged rest and catabolic state if fever.
Hope if you follow advise of r your Physician you will improve in few days.
Please take care
Good Luck.
Answered: Thu, 4 Apr 2013
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General & Family Physician Dr. Sunil 's  Response
Thanks for posting your query.
Typhoid can present with jaundice and fever, as S.typhi resides in gallbladder and may cause its inflammation (cholecystitis) which leads to jaundice.
According to your description you may be having one of following possibilities.
1) You may be experiencing relapsing typhoid fever. Recent studies shows S.typhi harbors tiny stones of gallbladder and continue their life. It can be treated with same treatment and widal test is repeated.
2) Your titers are not much raised, it may show previous typhoid fever. Total bilirubin is not much raised and may return to normal levels with in few days.
3) Sometimes in few patients bacteria may reside in gallbladder for many years without causing symptoms so they turn into carriers and continue infecting others. In such conditions minor surgery may be required to remove gall stone or whole gallbladder.
Suggestion: You should visit your health provider, restart your treatment with antibiotic (Chloromycetin or Ceftrixone). then repeat your Widal test and stool culture.
You should take light and soft diet with fluids, avoid high cholesterol unsaturated fat.
Hope it helps.
Take Care!
Answered: Thu, 4 Apr 2013
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General & Family Physician Dr. Himaja Bai Kethavath's  Response
Dear Tushar,

Welcome to HCM and thanks for posting your query here.

Widal test is presumptive test for salmonella typhi infection which is the causative bacteria for typhoid or enteric fever. A rise in the titre from 80 to 160 or so on gives a clue for persistent infection. Please compare your titres from the beginning of treatment. The confirmation of enteric fever or typhoid will be isolation of salmonella typhi from blood culture. Cause so many other infections, for example malaria will interfere with the widal titre.

It seems to be active infection is there cause there is continuous evening rise of temperature is there. Sometimes if the immune status of the body is low, it will take time to recover from the enteric fever.

Salmonella typhi will habitat in the intestine mainly. Hence the digestive capacity will get affected. Hence you are advised to eat easily digestable foods like idly, bread, cooked vegetables. It will be helpful if you avoid non-veg and egg for some period.

Take care while having outside food. Because typhoid comes from food and water which is contaminated with faeces of an infected person. Take boiled water for some days.

Get a check of malaria which is commonly associated with typhoid. Antibiotics like co-trimoxazole or third generation cephalosporins like ceftriaxone will help you in curing the disease.

Hope this is helpful to you

Answered: Thu, 4 Apr 2013
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