What are the reasons for high fever with chills, headache and vomiting?

Q: My sister, 22 years old has severe fever for the last five days and her temperature is not coming down. She first started vomiting which lasted for about four hours (with no blood in vomit). The same night she got severe headache with high fever. She started speaking incoherently and there was weakness & chills. The fever and headache are still persisting. Please advise me. She is living in a village in Bihar and the doctors there are not able to cope with the problem.

A:From what I understand your sister 22 ys old has high fever with chills for last 5 days associated with vomiting and headache. Please tell me more details i.e. degree of fever, any loss of consciousness, any fit or seizure, any burning sensation while passing urine.The list of probable diagnosis in such a patient would include:1. Meningitis, Viral encephalitis or Cerebral malaria2. Acute Sinusitis3. Typhoid4. Malaria5. Urinary tract infectionYou should get the following tests done:1. Complete haemogram2. P.S. for malaria3. Malaria antigen4. Liver function tests5. Blood C/S6. urine R/E7. X ray Chest PA viewPlease let me know the reports, I will try to be of some help. She would need antibiotics by the injection route. If you feel the doctors at your place are not able to diagnose, it will be a good idea to take her to Patna Medical College and Hospital - PMCH, where she can be admitted.