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What Causes Recurrent Fever And Weakness When Suffering From Typhoid?
Question: I am a female with 40 years of age. I was diagonised with Typhoid (No stool examnination was performed; only through Widal test result, it was diagnosed as typhoid). I was administered oral anti-biotic medicine for 5 days followed by 14 Monocef injections (2per day for 7 days) . The fever came down and I was ok for roughly12 to 15 days. After that i developed low grade fever with headache (It has been 2+ weeks since I am suffering from this). I went to another doctor who has repeated Widal test and confirmed that typhoid did not relpase. He also exhibited a doubt if I was ever having a typhoid. (he says that titor values in Widal test alone can't detemine typhoid). Malraia test also came out negative. Chest X ray, CT scan of Chest, CBP..all these test were repeated and they came out clean.... Dotor wanted me to wait and see... There was no fever for roughly 4 days and today the fever came back again (body temparature ranges anywhere from 97 to 99.5 during the day). Though my headache is more or less gone now, the fever is still on.. Weakness is on. No other specific symptoms. Can anybody help.? Should i wait for some more time or visit the doctor again?
Brief Answer:
Explained
Detailed Answer:
Hi XXXXXXX
I am Dr Mittal
I have read your query
And am going to try to help you understand the problem.
First and foremost, normal body temperature is 98.6 and the diurnal variation of 1 degree makes its range from 97.6 to 99.6. So ideally, the temperature range you have quoted as fever is normal.
Second, I agree with your doctor that titres are not enough. therefore I will suggest another test- Typhi Dot IgG and IgM. It will give a better idea whether or not it was typhoid
(CANT SEE THE REPORTS ADDED- THEY ARE PASSWORD PROTECTED)
Your treatment for typhoid was adequate. Assuming it was not typhoid, the antibiotic given to you would have covered most infections. So I dont think you have to worry about more antibiotics.
I personally feel that typhoid/whatever other infection we consider has left you weak. And this is making you feel unwell that you interpret as fever (your temperature range quoted by you is normal- as explained already).
I think you should focus on your diet. Also, I usually prescribe a course of 10 days of ciprofloxacin further in patients of typhoid.
The typhoid takes a long time to recover after antibiotics are over. i would suggest you be a little patient.
Best of luck
Dr Mittal
Explained
Detailed Answer:
Hi XXXXXXX
I am Dr Mittal
I have read your query
And am going to try to help you understand the problem.
First and foremost, normal body temperature is 98.6 and the diurnal variation of 1 degree makes its range from 97.6 to 99.6. So ideally, the temperature range you have quoted as fever is normal.
Second, I agree with your doctor that titres are not enough. therefore I will suggest another test- Typhi Dot IgG and IgM. It will give a better idea whether or not it was typhoid
(CANT SEE THE REPORTS ADDED- THEY ARE PASSWORD PROTECTED)
Your treatment for typhoid was adequate. Assuming it was not typhoid, the antibiotic given to you would have covered most infections. So I dont think you have to worry about more antibiotics.
I personally feel that typhoid/whatever other infection we consider has left you weak. And this is making you feel unwell that you interpret as fever (your temperature range quoted by you is normal- as explained already).
I think you should focus on your diet. Also, I usually prescribe a course of 10 days of ciprofloxacin further in patients of typhoid.
The typhoid takes a long time to recover after antibiotics are over. i would suggest you be a little patient.
Best of luck
Dr Mittal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Sir,
Thanks for your promot reply. The password to open both the files/reports is 'tv9226'. You can look at the reports.
Do you suggest now that i get Typhi Dot IgG and IgM test done and send you the reports? Also, some of my friends suggested that I get my Liver Function Test done. Is it needed? (I got my abdomin scanning done as part of many tests and the doctor found nothing wrong with the report) . My apetite is OK, but I am not able to eat well becuase of ''feverish' feeling and bitter taste in mouth.
I have absolutely no problem in waiting for more time. However, sometimes i get concerned if there is any other problem within my system. (hence i got CT scan of chest, abdomin scanning, chest X-ray etc done). Any rough guesstimate on how long should I probably wait for this ''feverish' kind of feeling and weakness to go away (it has been 2+ weeks since the fever is back...ofcourse with intermitent break of around 4 days) . Also, please let me know if you want me to send you more reports so that i can upload them. (if you want to look at any specific reports, let me know so that I can upload the same).
Thanks for your promot reply. The password to open both the files/reports is 'tv9226'. You can look at the reports.
Do you suggest now that i get Typhi Dot IgG and IgM test done and send you the reports? Also, some of my friends suggested that I get my Liver Function Test done. Is it needed? (I got my abdomin scanning done as part of many tests and the doctor found nothing wrong with the report) . My apetite is OK, but I am not able to eat well becuase of ''feverish' feeling and bitter taste in mouth.
I have absolutely no problem in waiting for more time. However, sometimes i get concerned if there is any other problem within my system. (hence i got CT scan of chest, abdomin scanning, chest X-ray etc done). Any rough guesstimate on how long should I probably wait for this ''feverish' kind of feeling and weakness to go away (it has been 2+ weeks since the fever is back...ofcourse with intermitent break of around 4 days) . Also, please let me know if you want me to send you more reports so that i can upload them. (if you want to look at any specific reports, let me know so that I can upload the same).
Brief Answer:
specific answers to specific questions
Detailed Answer:
Hi
I would like to look at your widal report
And yes I will suggest typhi Dot tests.
LFT is not really needed. If you like, you can have it done.
Also a urine routine would be a good idea.
If any of the above have been done recently, kindly upload the report first, before giving a new sample.
Best of luck
Dr Mittal
specific answers to specific questions
Detailed Answer:
Hi
I would like to look at your widal report
And yes I will suggest typhi Dot tests.
LFT is not really needed. If you like, you can have it done.
Also a urine routine would be a good idea.
If any of the above have been done recently, kindly upload the report first, before giving a new sample.
Best of luck
Dr Mittal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sir,
I have uploaded the following documents
1. Widal-24th XXXXXXX - Based on this report, I was disgonised as typhoid patient
2. Widal-5th Aug --- This is the report that I got recently done (when they suspected if typhoid re-occured and confirmed that it did NOT)
3. Complete Urnine - 24th XXXXXXX - Test done along with Widal test
4. Urine Culture -11th Aug - Test done when the fever re-occured
I have uploaded the following documents
1. Widal-24th XXXXXXX - Based on this report, I was disgonised as typhoid patient
2. Widal-5th Aug --- This is the report that I got recently done (when they suspected if typhoid re-occured and confirmed that it did NOT)
3. Complete Urnine - 24th XXXXXXX - Test done along with Widal test
4. Urine Culture -11th Aug - Test done when the fever re-occured
Brief Answer:
Responses to the reports
Detailed Answer:
Your report 1 and 2 are significant for mild anemia.
I will suggest a course of multivitamins for the same.
And repeat Hb after 1 month of multivitamin course.
Your report on 5th august is borderline specific for typhoid.
I wont discard it as insignificant.
the report may be indicative of improvement after typhoid.
Personally I would not have recommended a second test.
This is especially in view of the first Widal report.
I will still suggest a typhi dot test.
Urine routine and culture are both negative
Best of luck
Dr Mittal
Responses to the reports
Detailed Answer:
Your report 1 and 2 are significant for mild anemia.
I will suggest a course of multivitamins for the same.
And repeat Hb after 1 month of multivitamin course.
Your report on 5th august is borderline specific for typhoid.
I wont discard it as insignificant.
the report may be indicative of improvement after typhoid.
Personally I would not have recommended a second test.
This is especially in view of the first Widal report.
I will still suggest a typhi dot test.
Urine routine and culture are both negative
Best of luck
Dr Mittal
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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