Hello,
Welcome to Health Care Magic.
Thanks for writing.
I am Dr.Saddiq ul Abidin. I have read you question completely, i understand your concern and will try to help you in best way possible.
The kind of symptoms you have mentioned, and then belonging to South Asia, makes
Enteric fever aka typhoid, a most probable diagnosis, however it would have been more appreciable if we had known whether or not, any history of altered bowel habits, or any suspicion of a concomitant infection, whether urinary or respiratory exist or not?
Provided the information, you have shared, I would like to clarify one thing that
widal test is considered obsolete in many parts of the world now, and the most reliable test would have been a
blood culture, even typhidot has also got a lower specificity to the Enteric fever. An associated decrease in WBC count along with some other cell lines in your CBC, can also rise the possibility of typhoid.
Here I would suggest that you may need a repeated LFTs monitoring, as enteric fever has got the tendency to have complications like enteric hepatitis.
If you were my patient, i would have recommended you tab.
Ciprofloxacin 500 twice daily for 10-14 days, even if the fever subsides, to avoid chronicity of the infection. If no response is achieved in 5-7 days, then addition of
azithromycin 250mg twice daily to the current regimen has shown to increase the efficacy and better clearance rates.
Along with that, use of antipyretics, and motility agents, like
domperidone would have been more comforting.
If god forbid, the infection persists, and there is no other signs or laboratory findings suggestive of any other organ system involvement, based on the history, Indoor treatement with IV
ceftriaxone 2g twice daily would have been the next relevant thing to do, but iI hope the things will not go to that extent hopefully. Stay connected to your doctor and keep on seeking regular advice and checkups.
I hope this answered your question.If you have more queries I am happy to answer. Otherwise rate and close the discussion
Regards,
Dr.Saddiq ul Abidin
M.B.B.S(Licensed Family Physician)
Resident Medicine.