Brief Answer:
I would like to get widal test and typhidot test done

Detailed Answer:
Hello

Thanks for the query

You have mentioned that she had typhoid and has been received antibiotic Cefixime.
I have few queries
1)How the diagnosis of typhoid was made(hemogram,widal test,typhidot,blood culture)?
2)For how many days she has received cefixime and with what dose?
3)Any associated symptoms like pain abdomen,loose stool?

This fever can be due to incomplete treatment/resistant typhoid or any new infection.
The raised SGOT and SGPT is suggestive of liver involvement and can occur in typhoid also.
I would like to get a hemogram(to see the severity of infection),CRP (to correlate the severity of infection as it is a better marker),blood culture(to find the organism),widal test(to correlate with the previous widal test),typhidot(it is a better test for typhoid),urine examination(for any urinary infection).

Please attach the previous reports and prescription(will help if I would get any clinical finding mentioned).
Before starting any antibiotic or specific treatment I would suggest you to get all these test done so that a proper diagnosis could be made.
Give paracetamol for fever.

I hope this helps.
Waiting for your reply.
With regards

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Brief Answer:
Dose of cefixime is 20 mg/kg/day in typhoid

Detailed Answer:
Thanks for writing back

I have gone through the reports.The widal test is suggestive of typhoid. Cefixime is the first choice of antibiotic in typhoid and the dose should be 20 mg/kg/day in two divided dosage.
The average weight of 8 year old child is about 20 kg.The initial dose of 75 mg twice a day was very low.Even the current dose appears to be low(400 mg per day for 20 kg).
I suggest you to monitor the temperature and general well being.
if with the adequate dose of cefixime fever is not responding till day after tomorrow I would like to add one more antibiotic like azithromycin or ofloxacin.

Regards

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Brief Answer:
I won't recommend Lariago if fever shows a decreasing trend

Detailed Answer:
Thanks for follow up

Temperature more than 100 F is considered as fever.As fever is showing a decreasing trend it means that antibiotic is working.
Lariago contains chloroquine an antimalarial.
The possibility of two diseases at a time is unlikely.
The fever of malaria is usually high grade and associated with chills and rigor.
So I wont recommend Lariago as
1)Fever is decreasing
2)It is not high grade and not with chills and rigor
3)Malaria test has not been done

Continue giving cefixime and azithromycin.If fever persists or increases further investigation and upgradation of antibiotic may be needed.

Please ask if you have any more query.

Regards

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