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How is typhoid fever diagnosed?

Q: My 4.5 years old son is suffering from fever for the past one month. Widal test was done after 7 days. It showed TO 1:320 and TH 1:320. AH and BH were both negative. Doctor diagnosed it as typhoid and prescribed cefixime for 10 days. After taking this medicine, fever level came down. But fever recurs after 10 hours. How many days does it take for typhoid to get cured? Even after taking antibiotics for 10 days, my sons fever hasn't cured. Is there a restriction on fruits and vegetables in typhoid?

A:First of all the diagnosis of typhoid fever is not confirmed; since the widal test gives indirect evidence and though the titre of TO and TH are high, there are other conditions which may give a similar reaction, the most notable being previous immunisation against typhoid. The best method to diagnose typhoid fever is to do a blood culture, and the bacteria (Salmonella typhi, or Salmonella paratyphi A in paratyphoid fever) can be isolated and antimicrobial susceptibility determined. The average period of defervescence, i.e. the temperature coming back to normal, is around 4-5 days, on average. Please check if the dose of Cefixime was 20mg/kg/day, since failure to respond could be due to inadequate dosage. In enteric fever, high roughage diet is avoided in the acute phase of illness to prevent intestinal perforation, though the risk is not very high. There is no restriction on fruit juices.


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