Dr. C. Elanchezhian
General Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi,
My mother has a fever of around 104 degrees Fahrenheit. She is also having vomiting and coughing. I am sure it is not malaria, dengue, typhoid, UTI, or COVID infection. She had a history of typhoid a few years back. Her current medications include Tazloc-H, Glador, and Paracetamol. We got her urine culture done from a lab. What could the problem be? Please help.
Hi,
Welcome to icliniq.com.
I read your query and understand your concern.
The symptoms suggest that it is a viral fever.
I suggest you try the following medications for three days-
1. Capsule Pan-D (Domperidone and Pantoprazole) two times daily before food.
2. Tablet Doxy (Doxycycline) 100 mg twice daily.
3. Tablet Dolo (Paracetamol and Mefenamic acid) 650 mg twice daily.
4. Tablet Montair FX (Montelukast and Fexofenadine) two times daily after food.
As soon as urine test results come, please inform.
Thank you.
Patient's Query
Thank you, doctor,
Her fever did not get controlled by oral medicine, so we had to admit her to a hospital. The tests that were taken during and before the admission have been uploaded. She had shivers, and her sugar level increased drastically after taking certain medications. The fever is controlled now, and we were not satisfied with the treatment and diagnosis, so we discharged her after two days. The report before admission shows that she had an ESR of 22 mm/hr, and after it increased to 42 mm/hr. The earlier report showed typhoid negative, but now It shows positive. Her sugar level is 180 mg/dL now. Is there any other test we have to take? And is the diagnosis correct? Could you please tell me? And she has pain in her left lower abdomen and coughs sometimes. No other symptoms. No fever now. Please help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
SGOT (serum glutamic-oxaloacetic transaminase) and SGPT (serum glutamic pyruvic transaminase) are raised, so fever may be due to scrub typhus.
For this already, we have given tablet Doxy (Doxycycline) 100 mg twice daily.
I suggest you add the following medications-
1. Tablet Taxim O (Cefixime) 200 mg twice daily for seven days.
2. Tablet Dolo (Paracetamol and Mefenamic acid) 650 mg once if fever persists.
3. You must try to keep sugar under control.
4. You can do a blood culture test.
Thank you.
Patient's Query
Thank you, doctor,
The doctor we consulted said that she has non-specific urethritis, PVOD, and SHTN. Does she have all these? And the scrub typhus is showing non-reactive on reports, so does she have it? What is increased BVM marking in chest x-ray?
Hello,
Welcome back to icliniq.com.
I understand your concern.
I consulted with my fellow pulmonologist regarding the x-ray chest. Bronchovascular marking increased suggests bronchitis. I have already suggested antibiotics for her. I changed her antibiotics due to increased levels of liver enzymes.
I hope everything will be fine soon.
Thank you.
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General Medicine
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