Q: I am 20 years old female. Last year I had an episode when my heart started to beat fast and I could feel a very deep and non-rhythmic beat. There was no pain though. I was unable to sleep well for a few days before this incident and used to get up suddenly for no reason. I also felt weak, slightly yellow and had fever. I got a blood test done which showed falciparum malaria. Other reports showed that I also had typhoid. I took treatment for both the diseases - Lumerax-80 twice daily for 3 days and Taxim-O for about 14 days. After it was over I took Malarid for about 14 days and everything seemed fine for the next 3 months but after that I had recurrence of the symptoms. The test again showed falciparum malaria. I was given 6 Falcigo injections (twice daily for three days) and I got relief for next 15 days when again I had slight shivering in my body, pain and headache. This time I took homeopathic medicine, which gave me relief for 2 weeks till the time took the medicine. After completing the course of homeopathic medicine I started having pain on left side of my stomach, fever and slight shivering. I got my blood tested again and it showed typhoid. I consulted another doctor and he told me that I still have malaria along with typhoid. He gave me 6 Rapither injections once daily. I also took Ceurox tablet for 10 days twice daily along with some food supplement tonic. He also told me that my spleen had enlarged. The treatment has reduced my weakness although the fever remains. Even though the treatment is over, I still have fever and fast heart beat along with weakness. What should I do since the fever is recurring? What tests should I undergo and what food should I eat? Please help.

A:It is unusual that falciparum malaria should happen repeatedly unless you are in an area where malaria is rampant. Generally vivax malaria tends to relapse, not falciparum and primaquin / malarid is used in the former for a radical cure. Typhoid would relapse if inadequately treated or consuming contaminated water. Generally 14 days of cefixime in a dose of 400 mg twice daily should have been sufficient. Is your blood culture positive? Widal can remain positive for a long period of time and only a rising titre would be significant. In case fever is persisting, other investigations like chest x-ray, USG whole abdomen, urine routine, mantoux test, stool culture need to be done. An echocardiography for the heart maybe warranted if palpitations and fever persist.

You can consume most of the tertrapack juices as these are hygienic and generally preservative free. Take care about hand hygiene, food and water precautions .If other members of your family had typhoid, check the water supply. The rest of the family maybe vaccinated for typhoid. Avoid uncooked food while eating outside. Food which is freshly cooked is considered safe.