Enteric Fever

Male patient aged 17 years was under treatment for Enteric Fever from me as per his Widal test reports from 3rd March. Has high grade fever esp in the evening and night to almost 105degree F Cefixime 200mg BD Azithral 500mg OD PPI Multivitamins Dolo 650 mg BD I ordered CBC, DENGUE SEROLOGY AND TYPHIDOT, MP Dengue Non reactive and TLC 5K, PLT -WNL, MP - Non reactive TyphiDot IgM IgG both reactive What changes need to be instituted for his enteric fever esp evening/night onset of high grade fever?? Antibiotics change?

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CT...ALL..AS IT'S.. IV.XONE .. IV.FLUIDS..SOS.. GLUCOSE SUPPLEMENTS.. REST..&.. FOLLOW UP..
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You are treating o k can change to ceftrioxone
PUO REPEAT CLINICAL EXAM ANY NEW SIGNS? Abdomen = liver spleen lymph nodes Perinal lesion abscess ? Neck glands Thyroid tenderness neck rigidity Nose throat chest heart = murmur Repeat INVESTIGATIONS Blood = procalcitonin CBC BLOOD Culture LFT ANTI LEPTOSPIRA IGM AB SCRUB TYPHUS IGM AB MALARIA DUEL ANTIGEN URINE C& S ECHOCARDIUM = VEGITATIONS OF INFECTIVE ENDOCARDITIS CXR USG = ABD
According to clinical scenario,high temperature small age, I prefer Iv ceftriaxone in place of cefixime ,do blood culture sensitivity and specificity to get an idea of sensitivity, n Starrt cold sponging in this patient, do Usg abdomen pelvis to check for liver, spleen n mesenteric lymph nodes
@Ankit Hissaria @Azam Mohd Please give your valuable opinion on this case sir
Kindly add oflox with cefixime 400 bd dose Tab Azithral 500 od Wait for 3 days If not responded Put on inj ceftriaxone
PL ADD TO MY POST PL EXCLUDE DRUG FEVER STOP ALL ANTIBIOTICS FOR 48 HRS TO EXCLUDE DRUG FEVER
Add ofloxacin 400mg bd Iv inj Ceftriaxozone Inj meteronidazole for anaerobic secondary infection
You are going well to the text.. Continue Dr.Ajitji.
Also give antimaralial rest cst

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