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Suggest Treatment For Persistent Fever And Fatigue While On Cefpodoxime And Ofloxacin
Question: Hello doctor
My husband 27 year old is suffering from fever from past two weeks. Fever was around 99'C with mild weakness for 4-5 days. And then it increased to 100C with fatigue and weakness.
We got hemogram done. All values came normal except RDW 16.10 and basophils 0.00.
ESR also came normal i.e 8.
Still be put him on cefpodoxime and ofloxacin tablets along with paracetamol 650 mg. He took this medication for a week. But the fever dint came normal even after medicines and high dosage of paracetamol. We revisited the doctor and he suggested Widal test. Results came out as ST'H' as 1:40 positive, rest all negative. I have a doubt that could it be false negative because he was on antibiotics?
Now he has been put up on meftal forte along with B complex. N his fever in between also shoots to 102C. N he feels a little cold. N he is losing his appetite and weight. Please suggest what could be the possible diagnosis and treatment?
Should we take Widal test again as now he is off the antibiotics?
Please help.
My husband 27 year old is suffering from fever from past two weeks. Fever was around 99'C with mild weakness for 4-5 days. And then it increased to 100C with fatigue and weakness.
We got hemogram done. All values came normal except RDW 16.10 and basophils 0.00.
ESR also came normal i.e 8.
Still be put him on cefpodoxime and ofloxacin tablets along with paracetamol 650 mg. He took this medication for a week. But the fever dint came normal even after medicines and high dosage of paracetamol. We revisited the doctor and he suggested Widal test. Results came out as ST'H' as 1:40 positive, rest all negative. I have a doubt that could it be false negative because he was on antibiotics?
Now he has been put up on meftal forte along with B complex. N his fever in between also shoots to 102C. N he feels a little cold. N he is losing his appetite and weight. Please suggest what could be the possible diagnosis and treatment?
Should we take Widal test again as now he is off the antibiotics?
Please help.
Brief Answer:
Typhoid fever is a possibility.
Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney. I understand your concern.
Widal test is a non specific test as it is antibody response and only the rising titres of widal test carry significance.
Antibiotics don't cause false positive widal test.
You should ask your doctor to repeat his widal test and if still no rise in titres, I would advice following investigations:
1. Complete blood count.
2. Malaria antigen.
3. Chest X-ray
4. Blood and Urine culture.
So get the investigations done and write back with reports for treatment discussion.
I hope it helps you.
If you have any further query, please ask me.
Typhoid fever is a possibility.
Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney. I understand your concern.
Widal test is a non specific test as it is antibody response and only the rising titres of widal test carry significance.
Antibiotics don't cause false positive widal test.
You should ask your doctor to repeat his widal test and if still no rise in titres, I would advice following investigations:
1. Complete blood count.
2. Malaria antigen.
3. Chest X-ray
4. Blood and Urine culture.
So get the investigations done and write back with reports for treatment discussion.
I hope it helps you.
If you have any further query, please ask me.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much Sir.
So antibiotics does not alter widal results at all?
Should we repeat widal test now or do we have to wait for 1 or 2 days?
Also his fever has not break since 2 weeks beside so many antipyretic drugs. Does it harm organs in the body? Will I.V treatment help?
So antibiotics does not alter widal results at all?
Should we repeat widal test now or do we have to wait for 1 or 2 days?
Also his fever has not break since 2 weeks beside so many antipyretic drugs. Does it harm organs in the body? Will I.V treatment help?
Brief Answer:
Detail follows.
Detailed Answer:
Hi.
No antibiotics don't alter the widal test.
You can get the test repeated after 3-5 days of the first test performed.
Yes definitely medicines have the side effects. However if need is there we need to give.
If tests confirm the diagnosis of typhoid he can be started on Injection Ceftriaxone.
I hope it helps you.
If you have any further query, please ask me.
Detail follows.
Detailed Answer:
Hi.
No antibiotics don't alter the widal test.
You can get the test repeated after 3-5 days of the first test performed.
Yes definitely medicines have the side effects. However if need is there we need to give.
If tests confirm the diagnosis of typhoid he can be started on Injection Ceftriaxone.
I hope it helps you.
If you have any further query, please ask me.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Sir, I Have attached the reports along with the text. Please see if it is positive for typhoid? Blood culture report will come in a few days. What should be the treatment plan. Thanks in advance.
Brief Answer:
I need previous widal report
Detailed Answer:
Hi, i need to see his previous widal test report for a better help.
I need previous widal report
Detailed Answer:
Hi, i need to see his previous widal test report for a better help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have send the report
Brief Answer:
Typhoid fever.
Detailed Answer:
As discussed previously, the titres are rising in nature , so we can hereby go ahead with the diagnosis of Typhoid fever.
I would recommend in such case Injection Ceftriaxone as well as oral Azithromycin.
Once started on treatment fever should respond with in 5-7 days and treatment should be continued for at least 2 weeks.
However after 1 week, Ceftriaxone injection can be converted to oral Cefuroxime.
Please share my opinion with your doctor.
I hope it helps you.
If you have any further query, please ask me.
Typhoid fever.
Detailed Answer:
As discussed previously, the titres are rising in nature , so we can hereby go ahead with the diagnosis of Typhoid fever.
I would recommend in such case Injection Ceftriaxone as well as oral Azithromycin.
Once started on treatment fever should respond with in 5-7 days and treatment should be continued for at least 2 weeks.
However after 1 week, Ceftriaxone injection can be converted to oral Cefuroxime.
Please share my opinion with your doctor.
I hope it helps you.
If you have any further query, please ask me.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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