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Will antibiotics help in curing high fever due to dengue?

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Will antibiotics help in curing high fever due to dengue?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Vivek Chail

Medically reviewed by

iCliniq medical review team

Published At August 25, 2018
Reviewed AtJune 14, 2023

Patient's Query

Hello doctor,

My daughter, 21 years old, has a fever (100 °F to 101 °F) and nausea for the last five days. She has a very low appetite and abdominal pain. Among all other tests, the CBC (complete blood count) test worries me. The test result reveals that her WBC (white blood cell) count is 3300 cells/μL, neutrophils 83 % and lymphocytes 11 %, and platelet count 101000 cells/μL. Her RBC (red blood cells) is 3.66 million/mm3, Hb (hemoglobin) 10.7 %. All other parameters including kidney and liver functions are normal. Doctors say that it is a viral infection, dengue. She has been advised to take Paracetamol, Omeprazole, B12 Vitamins, and Fefol tablets and also to take plenty of water. The fever does not get subsided completely. Do you think giving antibiotics would help her at this stage? Could it be a bacterial infection too? The doctor did not prescribe any antibiotics. I need a second opinion from you.

Answered by Dr. Vivek Chail

Hi,

Welcome to icliniq.com. I have read through your query in detail. Some of my observations are, your daughter has slightly low hemoglobin and platelets (attachment removed to protect patient identity). The normal hemoglobin is considered above 12 g/dl and platelets more than 150000 cells/μL. RBC count is less since 4.5 million cells/μL is the normal count. The total count is also less showing leucopenia, normally more than 4000 cells/μL and the neutrophil percentage is more and the lymphocytes percentage is less. There is NS1Ag (antigen) test showing positive which indicates the possibility of dengue infection. Rapid test and dengue ELISA (enzyme-linked immunosorbent assay) might appear negative now but will become positive after some time. Right now antibiotics are not required because there is no sign of bacterial infection. Fever will take time to respond and please give her Paracetamol after food every six hours for fever. Supportive care is important for dengue fever and that is the reason your doctor has prescribed Paracetamol for fever and pain and Omeprazole to prevent gastritis. Daily intake of water and fresh juice should be two liters and the diet should be 1800 calories daily. It is still in a mild stage and a regular platelet test is required for monitoring. The doctor might also tell you to get an ultrasound scan abdomen done to look for any water collection in the abdomen.

Patient's Query

Thank you doctor,

Should they start any antibiotics at this stage? Five days back, she was hospitalized and put on IV fluid therapy. The fever was continuous and high intermittently. She was conscious. Not taking solid food, taking only less semi-solid, very little khichdi, sliced fruits. Not able to retain whatever food in the stomach due to vomiting and also acidity. She has become very weak. A day later, she was given random donor platelets. But after giving her four units, it was stopped because of sudden high fever, rigor with tremendous agitation. With steroids, a high dose of Paracetamol injection, Avil injection, Voveran, or Diclofenac injection, the fever came to normal. When platelet infusion was given again and at a faster rate than before, she needed to go to the toilet in between. After three units of platelet infusion, it was stopped. She fell on the bathroom floor and became unconscious, blood pressure untraceable. She was brought to bed, and given an oxygen supply, and blood pressure-boosting medicines intravenously. Regained consciousness at night after about two hours. The next day, she was taken to ICU. She is semiconscious since morning. The platelet count dropped to 12000 cells/μL. The doctors are considering platelet transfusion again in the afternoon. The doctors are telling that it is a shock either DSS or sepsis. The doctors are reviewing the case and considering starting antibiotics also if things are not under control. Now, there is no fever. She is conscious but very weak. Not able to take even semi-solid food. There is a vomiting tendency and extreme pain. Only some little red rashes over the trunk and back.

Answered by Dr. Vivek Chail

Hi,

Welcome back to icliniq.com. It is important to give her urgent platelet infusion to bring up the platelet count. Since sepsis is suspected, a sample of blood should be sent to the laboratory for culture and sensitivity and powerful broad-spectrum antibiotics might be started until culture results come. Since she is in ICU, it is better to start antibiotics.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vivek Chail
Dr. Vivek Chail

General Practitioner

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