Q: My mother has a history of diabetes but nowadays the sugar never rises above 110 mg/dl without medication as she went into coma due to low sugar levels. She has a renal problem and her serum creatinine is 2.5. Her current problem now is fever. It has been there since 2 weeks and it goes upto 100.1 degrees. She has pus cells (+++) in her urine when last checked. The Widal test for typhoid has come positive at a titre of 320. She is currently on levomac 250 mg and the doctor says she cannot be given more medication. Her age is 64 years and she is on Bio D3 plus, conviron tr, folic acid, neurobion forte, alprax 0.5, gabapin 100 and pantop d. Her haemoglobin is 8.5 and weight is 49.5 Kgs.

A:Typhoid sometimes results in persistent fever by causing a low grade infection in the gallbladder and even in the bones where a chronic abscess may develop. Repeated physical exams will be needed so that the treating physician can decide about possible causes of the problem and decide if other tests or actions are indicated. In a fair proportion of cases of fever no causation can be found and the situation gradually resolves spontaneously. However there are numerous causes of fever and those that do not resolve are likely to result in some physical or laboratory findings that the treating physician can then address with specific treatment.