15 yrs boy...h.o...fever on off last 3 days....and shivering....lot of...when fever comes......fever upto.100...two to 3 episode....but shivering is lot of....no cough...cold......medicine given but can't rilife......live in local area....no any contact of....covid ....or other.....pls suggest line of treatment...on injectable....and iv..and diagnosis.....pr.90.min....spo2 98 %..@Dr. Shivraj Agarwal


This a c/o viral fever D/d 1 dengue fever confirm by dengue profile 2 covid19 infection adv xray chest And RT pcr Followed by sr ferritin D-dimer and LDH Sos procalcitonin Ecg Rx inj artisunate 60mg iv bd for 3days Inj Ceftriaxozone Inj dexamethasone Inj paracetamol ivdrip Inj ondestron Inj pantaprazole Review after 3days If rt pcr is positive than shift to covid hospital Check urine and r/o uti

Thanx dr Pooja L

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As fever is of 3 days duration with rigors- it looks like a,simple fever 1.Although in report it is,written widal test is positive but at titres of 1: 80 - positive- it is,not indicative of typhoid fever as titres above 1: 160 are considered positive. To rule out typhoid fever get his test for Salmonella typhi antibodies IgG and IgM. 2.It could be malaria,- so get malaria antigen test done in peak fever and also make a slide - PFF 3.As platelets are low - 118000 - it could be dengue fever - get dengue serology done . 4.It could be simple viral fever - which will subside after 5 days 5.Get a urine routine examination done as UTI can present with fever with rigors. Meanwhile- give Dolo 650 × 8 hourly- till reporta of all investigations are received

we have discussed it many times in the past too . widal test in second week of fever only . in the first week blood c/s is the investigation of choice . coming to ur case theres leucopenia and thrombocytopenia . two important diagnosis here dengue n typhoid here . do urine r/e n c/s too n ns1 igm dengue . start the patient on iv ceftriaxone and iv amikacin


Haemogram s/o mild leukopenia , thrombocytopenia with raised haematocrit. Continue antipyeretics every 4-6 hrly, IV fluids maintenance. Monitor BP , urine output . W/f rashes , eschar mark . D/d- Dengue , Ricketssial infection, malaria

Thank you@Dr. Shivraj Agarwal Sir

Fever with chill and rigor for 3 days may be due to A. Any viral fever including dengue B. Malaria C urinary tract infection Widal test positive on 3 Rd day if fever that even 1 :80 insignificant i Test for dendue and dengue antibody Urine for routine and culture sensitivity test and to give antibiotic if positive Otherwise Tab paracetamol Vitamins and antioxidant Vitamin C If there is cough with expectoration then broad spectrum antibiotic may be added.

Check for Dangue...Malaria... Salmonella typhus antigen test..

Go for dengue serology and symptomatic treatment

Tab. Moxclav 375mg bd for 5 days Tab. Ciprobid 250mg bd for 5 days Tab. Calpol 500 8 hrly for 5 days Syp. Liv 52 2tsp bd for 5 days.

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