Dr. Hariharan
Diabetology
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Dr. Hariharan
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Patient's Query
Hi doctor,
I am a medical student and my query is regarding my father. My father is suffering from fever, chills and rigor every month along with gastric problem. For gastritis, I am treating him with PPI (proton pump inhibitor) and Sucralfate. He had similar attack 15 days back. Since I had no clue about the cause, I gave him tablet Ofloxacin 200 mg twice a day. He usually develops gastric problem followed by fever with chills and rigor. I also got his ultrasound done, but there was no gallstone or appendix problem present. Now I have started giving him injection Ceftriaxone. His leukocyte count is 8600 and eosinophil count is 13%. Please help me to find the cause. Thank you in advance.
Hi,
Welcome back to icliniq.com. Though your dad is not having cough or cold that accompanies fever, his symptoms suggest that, it can be due to allergy or post-chikungunya syndrome. Did your dad get affected with chikungunya recently? If so, then he might have recurrent fever along with joint pain. This is referred to as post-chikungunya sequela. It can be corrected by taking oral steroids like Betnesol (Betamethasone) and Aceclofenac. If he never had chikungunya before, then it might be due to allergy. Check his AEC (absolute eosinophil count), CRP (C-reactive protein), and IgE (serum immunoglobulin E). Since malaria can come on and off, check for malaria and also get a widal test done. If none of the tests turn out to be positive, then we may consider it to be because of autoimmunity. Meanwhile, you can start with ayurveda immunity booster known as Septilin tablets. This tablet should be taken twice a day for a month. It will help to increase his immunity and stop his recurrent fever. To identify the gastric problem, we have to rule out colitis. For colitis, I would prescribe you to take a combination of Ofloxacin and Ornidazole twice daily for five days. My advice is, continue with Ceftriaxone and start Septilin along with a combination of Ofloxacin and Ornidazole.
Patient's Query
Hello doctor,
My dad is a known diabetic. His main worry is that fever occurs only when there is gastric problem. His widal and MP test results came negative. Can it be due to parasitic infection like eosinophilia? Can I give Ofloxacin along with Ceftriaxone? He has no joint pain or chikungunya. His Hb level is 10 g/dL. How to increase his Hb level? And also guide me with a good Iron supplement to avoid constipation.
Hi,
Welcome back to icliniq.com. The drug Ofloxacin and Ornidazole combination is mainly given for both bacterial as well as parasitic infections. This combination along with Ceftriaxone should be taken for five days. These drugs will help in clearing the main cause and stop fever. If the fever reoccurs, then I would suggest you to take him to a gastroenterologist. He may advice you to get a CT of the abdomen done, to rule out any mesenteric lymphadenitis. You can take tablet FA 20 mg (Famotidine) twice daily. This drug will not increase gastritis or cause constipation. Iron tablets alone will not help in increasing the Hb. He can take tablet Methycobal (Methylcobalamin) to improve his Hb count. Include proteins for iron absorption and take one egg daily.
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Dr. Hariharan
Diabetology
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