My friend is suffering from dengue and typhoid. The test for dengue showed a positive result, and typhoid titer is 1:360. Initially, he was treated with Ceftriaxone injection BD and Paracetomal for five days. But the symptoms got worse. His platelets suddenly got reduced to 21000 platelets per microliter of blood with petechiae and bluish lips. His SGOT, SGPT, and GGT are elevated. He has vomiting and diarrhea. Now, he is treated with fluid replacement, Doxycycline, Paracetomal, and tablet Ursocol.
Your friend appears to have severe dengue. Kindly do blood cultures for typhoid fever. Blood culture helps us to identify the presence of salmonella, and it guides the choice of antibiotic therapy. The petechiae can occur due to low platelet count. The bluish lips or cyanosis should be evaluated further. You have to do chest X-ray and arterial blood gas test soon. I suggest you do an holo-abdominal ultrasound and a plain abdominal X-ray. Elevation in liver function tests are seen in dengue or typhoid, and the liver can be enlarged in dengue. But intestinal perforation is the catastrophic complication of typhoid fever. I would recommend aggressive fluid resuscitation. If there is any sign of severe bleeding or unstable vital signs, a blood transfusion can be given with fresh whole blood or fresh packed red blood cells. Ceftriaxone always works well for typhoid fever. Identifying the complication is essential. I hope this helps. Thank you and take care. Regards.
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