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What Does My Lab Test Report Indicate?

Posted on Tue, 13 Sep 2016

Question: Hello Doctor

My mother went sick viral day before yesterday with 103.5 deg. fever. We were advised by Dr. XXXXXXX to give Dolo 650mg as there were no other symptoms besides Fever, Body ache & Shivering. Tablet thrice a day.

She is normal on fluids and little low diet. But the fever has come down from

103 deg at 8am
101.8 at 11am
103 deg at 3pm
101.6 at 6pm

In the meanwhile we got her CBC tested this afternoon (Report attached). Please interpret the report and let us know the next course of action and possibility of dengue or something. She doesn't have joint pains or vomiting but pain in both the palm and unable to tightly hold her fist.

Answered by Dr. Shashi Dangwal (1 hour later)

Brief Answer:
A course of antibiotics may help.

Detailed Answer:

Hello XXXXXXX

I have gone through your mother`s blood test. The reports appear normal except that there is mild increase in the her neutrophil percentage(83%). This may indicate some superadded bacterial infection. A course of broad spectrum antibiotics like azithromycin 500 mgm daily or cefexime 200 mgm twice a day for 5 days may resolve the fever.

I suggest that if she continues to run fever, you may repeat her investigations which should include tests for dengue fever including platelet count, widal test for typhoid and a urine test to rule out urine infection.

Till dengue ie ruled out she should not take any other antipyretic( medicine to bring down fever) beside dolo 650. She should also avoid blood thinning agents like aspirin/dispirin till then.

I hope this answers your query

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Shashi Dangwal (1 hour later)

Thanks Doctor, can we for now continue with Dolo 650 instead of starting antibiotics.

She is not taking any other medicines besides Dolo 650.

Just measured her current fever is the highest tell now 103.8 deg.

We just started wet cloth on her forehead to cool down the temperature. My developed similar thing since Sunday but his but his fever is 99 now with body weakness. He was treated with Dolo 650.

My mother started Dolo 650 from 23.08.2016 at 4pm.

Should we just continue with it tomorrow as well or directly go for urine & Widal test tomorrow itself.

Please let me know.

Answered by Dr. Shashi Dangwal (14 hours later)

Brief Answer:
You may wait for some more time if her general condition is all right.

Detailed Answer:

If her general condition is all right you may watch for another 24 to 48 hrs. Monitor her condition regularly and if there is no improvement then I suggest you go for the tests as suggested above including tests for dengue fever.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Shashi Dangwal (48 minutes later)

Her fever has moved down from 102.6 (at 8:15am) to 99.6 now (1:15pm). Weakness is still there but there is some improvement. No dearth of fluid, has started Vit C tablet as well once a day.

Her tests (CBC, Widal, Urine) will be coducted at 2:30pm today. I will share the reports with you with further observations by late evening today.

Answered by Dr. Shashi Dangwal (16 hours later)

Brief Answer:
Good that your mother is improving

Detailed Answer:

Good to hear that your mother is improving.

Do post the reports asap so that I can have a look at them.

Take care.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Shashi Dangwal (27 hours later)

Hello Doctor

Find attached the report for your reference. There is no fever and weakness is less now. Is there a point of worry in the report. Please elaborate.

Answered by Dr. Shashi Dangwal (6 hours later)

Brief Answer:
She may need a course of anti typhoid antibiotics

Detailed Answer:

Your mother`s widal test for typhoid is positive. Her TLC and platelet counts are also on the lower side.

At times widal test may give false positive results. Hence I suggest you consult your local physician who may examine her and may prescribe anti enteric antibiotics if required.

Low TLC could be because of typhoid fever or viral infection. This can be repeated after 2 to 3 weeks and I am sure it will come out normal.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Shashi Dangwal (1 hour later)

Hello Doctor

We just consulted our local family Physician just now. He has given some medicines and have confirmed Thyroid based on the medical records and have prescribed a 7 day course. We plan to complete the entire course on time and keep a proper balance nurition this phase.

Do you suggest to repeat the test (just the widal or anything else) after a week or 2/3 weeks. Please suggest.

Thanks for all the help.

Hello Doctor

Three more questions -

How long does it take to get rid of weakness related to typhoid
Is it alarming for Platelets to reduce 20k from 153K to 133K ?
How can we quickly increase Platelets count by meal - I have heard that Kiwi fruit aids in increase in Platelet count.

Answered by Dr. Shashi Dangwal (13 hours later)

Brief Answer:
Complete the course of antibiotics. 20k platelets is alarming.

Detailed Answer:

Its good that she has already been started on anti typhoid treatment. You may repeat the test after some time but it may remain positive for sometime so don't be alarmed.

She will get over her weakness in due course of time. Let her have nutritious food.

Yes for platelets to fall down to 20000 is alarming because chances of bleeding may increase but the reports sent by you show her platelets at 133k.

Platelets start rising on their own and rise very rapidly. I`m not aware of any such thing as mentioned by you. Just keep the person under observation for any bleeding or better to put him/her in hospital so that platelet transfusion can be started asap if required.

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Raju A.T