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Q. My close relative is diagnosed with typhoid, and she has a throat infection. Please help.

Answered by
Dr. Manisha
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 10, 2020

Hi doctor,

I am writing this for my close relative. A local doctor diagnosed her with typhoid. She also has a throat infection. I am attaching herewith the reports for your reference. Please confirm and advise the medicine for the same.

#

Hi,

Welcome to icliniq.com.

The first report (attachment removed to protect patient identity) that you have provided is a complete blood count, and that does not say anything about typhoid. However, the second report shows the Widal test results, which confirms the presence of active Salmonella typhi infection. Typhoid fever diagnosis is more of a clinical diagnosis than a lab one. In the presenting complaint, you have mentioned throat infection, but nothing about fever, abdominal pain, diarrhea, and any other symptoms. To prescribe the right medicine for her, I need a more detailed history. Onset and duration of the complaints also.

Thank you, doctor, for the reply.

She says that she does not have a fever or any abdominal pain. She had loose motion only once in the last ten days. She does feel drowsy during the day and has a dry cough. Please advise and possibly prescribe medicine as she has joined a new job and cannot afford to stay home.

#

Hi,

Welcome back to icliniq.com.

Thanks for the information. Whatever details you have provided and test reports, I can gather that she may be having a very mild infection. Since it has been more than ten days and has just a few symptoms, she may be already recovering from the illness. Her drowsiness and lethargy could be partly due to low hemoglobin levels. I would advise getting hemoglobin levels checked again after she recovers completely.

1. Tab Ciprofloxacin 500 mg twice daily (Every 12 hours) for five days.

2. Tab Pantoprazole 40 mg once daily on an empty stomach for five days.

3. Drink at least eight glasses of water per day.

4. Avoid fried and spicy food for the next two to three weeks.

Report back if there is any allergic reaction to the medication. Repeat CBC after one month.


Investigations to be done:

CBC (complete blood count).
LFT (liver function test).

Hi
As advised, we have got the CBC and LFT done and are attached herewith. She does complaint about boils in her mouth and feels difficulty in swallowing anything. A feeling that she may have boils there as well. Please advise the next course of action please.
# Hi, Welcome back to icliniq. The ulcers in mouth and Throat could be due to two reasons. First is the recent abdominal infection that Sonam had. The second one beings, Anemia. The blood reports that are provided show anemia , which points towards iron deficiency anemia. Her LFT reports shows mild rise in ALP which is a common finding in typhoid and this resolves gradually on its own. Iron deficiency anemia most commonly results from decreased intake of iron or increased loss. Usually there are few more tests done to confirm the diagnosis but as of now I would ask her to take iron supplements for at least a couple of months before repeating the test. Sonam can take Haem up capsule once daily for 2 months. It should preferably be taken with some juice or fruit. Also Cap Becosules z once daily at night time after food. for one month. Zytee RB gel can be applied on oral ulcers for some pain relief twice a day.
In case Haemup capsules are not available, other alternatives such as dexorange capsules can be taken.
It is advised to repeat CBC after two months of taking oral iron supplements. If HB remains low then she will need further investigation
These should help her.
Investigations to be done:

Repeat CBC after 2 months

Treatment plan:

cap Haem up-1 cap per day with fruit /fruit juice
Cap Becosule-z 1 capsule per day for one month
Zytee RB gel for local application in mouth
Try to include more of pomegranate and beetroot in diet.

Regarding follow up:

Follow up after 2 months with CBC report


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