32yr Female ..C/o..High grade fever with chills ..s.headache from 15days h/o .d&c 25days before..R.b.s 114 ..other investigation below ...severe anaemic ..widal positive ...vitals normal pulse increased...Need your opinion docs




Severe Iron deficiency Anaemia w Typhoid fever w PID.Blood transfusion,Injury Cefrrixone 1 gm IV bd,Injury Linezolid 600 mg IV bd,PPI,pre & pro biotics,Injury Metronidazole 500 mg IV 8 hourly,Vaginal doutch w betadine 4 hourly,PCM,Vit B complex,Injury Onsansetron IV sosAfter pt gets stable do USG of Lower abd to exclude any retained product or highly thickened endometrium,if so plan should be taken for D&C with very aseptic measure

Microcytic hypochromic anemia most common cause is iron deficiency anemia. Below 7% you require blood transfusion. Also give Iron. In view of fever and D&C you must do a USG abd and pelvis to r/o RPOC. Widal is not very specific test for enteric fever. Also do urine examination. Malaria antigen test. Start I/V antibiotics ceftriaxone and metronidazole.

Cefixime 200 bd Oflox 200 bd Correct anemia with iron + mvbc Maintain hydration Monitor of result of iron suppleme. If not rule out otherr cuase of anemia

Blood for Procalçitonin Bactec Blood culture Urine culture Malaria duel antigen are the investigations .to be done...Severe anaemia and septicaemia ...possible diagnosis

Enteric fever with anaemia Rx cefixime 200 mg + Ofloxacin bd Pcm 650 mg tds Multifresh syrup bd Ondet md tds

Treat typhoid fever.Treat iron gef.anaemia.review at tehular intervals

Enteric fever with anaemia Rx Omnix-O BD for 14day calpol 650 TDS and given Rubired tab for 1month

Treat typhoid fever..treat iron def.anaemia.review at regular intervals

Please do urinalysis & blood culture: Hope no bleeding p/v:treat it with ceftrixone, levoflox, metrogyl: two units of packed cells. Hope D&C was under asceptic conditions.

Also get typhidot IgM. And may give cefixime ofloxacin+ornidazole(because h/o d n c is there

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