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Causes For Persistent Fever During Typhoid Treatment?

Posted on Fri, 24 Jan 2014

Question: 5 year old is treated with IV antibiotics for 8 days but the fever hasn't subsidised. She gets fever once every 8 hours, before treatment it was once every 4 hours. no other symptoms, the girl is active and otherwise normal. What could be reason for fever still? When the girl got admitted to hospital the CRP was 12, after 8 days it is 24. Shouldn't it go down after treatment? does she have any other infection? By the way the infection was typhoid.

Answered by Dr. Indu Kumar (1 hour later)

Brief Answer: She may need antibiotics for one additional week. Detailed Answer: Hello XXXX Thanks for writing to XXXXXXX There is little possibility of other infections.Typhoid test is confirmed by widal test which is very sensitive test. Generally 8 days I.V treatment is sufficient in most of the cases.High grade rising fever is the feature of typhoid.Your daughter is showing some residual effect.Don't worry.She will be alright.You can talk to your pediatrician to continue drugs for one more week .She can be switched to oral medicines now. CRP increases during typhoid fever and many other conditions.Initially it increases during disease process and after control of infection it starts declining and it take time to decline,so don't worry about this. Your daughter need control of fever only and it can be done by antibiotics,so better to consult your doctor. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (2 minutes later)

Are you saying the fever will still be present even after finishing 8 days of antibiotics? How long it will take fever to subside.? Our doctor is thinking of giving steriod to kick out fever, is it good choice?

Answered by Dr. Indu Kumar (7 hours later)

Brief Answer: Short course of steroids can be given. Detailed Answer: Hello XXXX Thanks for writing back It may take 4-5 more days for complete resolution.Duration may vary from patient to patient. Use of steroid in typhoid fever is debatable. In my opinion,it can be given in your daughter case.Short course of steroids can be given. It is avoided after 2 weeks of fever. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar