Enteric fever

10yr girls complain of abd pain Vomiting fever Past treated with local practitioner with some antibiotic and antispasmodic Chief Complaints Abdomin pain ×5 days Vomiting with giddiness Vitals Bradycardia Physical Examination Redness over face with swelling P/A_ mild hepatomegaly ,rif tenderness CVS_ soft s2 R/S _NVBS Investigations WBC_ neutrophilia High RBS USG_ ?ceacum pathology Diagnosis Typhicitis Enteric fever Management Inj. Ciplox 500mg (100ml) od Inj. Drotin bd Inj. Finecef 750mg bd Inj. Reni +onda+pan40 Inj. Pcm sos ×2day After orally 5 days

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Tab. Cefixime 200mg bd Tab. Azithromycin od Tab. Calpol 500mg. Bd Cap. Vizylac 1od

Some Doctors after all med.related to fever adv.ATT treatment for a short time.

First confirm Enteric, gold standard is blood culture which may not be positive because of previous antibiotic therapy, if oral intake good, no vomiting, one can choose oral cefpodoxime 20mg/kg/day bd,azithromycin can be added but I prefer single drug therapy, good hygiene Pre/probiotic,vitc 500mg od

High RBS No lab evidence for typhoid Its blood culture or atleast some antibody testing How high is the RBS Typhoid will have leucopenia Ceftriaxone would drug of choice R/O diabetic ketoacidosis also if RBs very high

We first use cefixim+ofloxacillin for 10 days. If fever not subside then add azithromycin for 5 days. With supportive treatment treatment. Blood culture is gold standard
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Tab mahasudarsan vati  2tab tds Tab ARogyavardhni vati 2tabtds Syp Vzym  10ml BD Tab Giloy ghan vati  2tab tds  Tab Agnitundi vati  2tab madhu ke sath

Sarv jarhar loh braht with swarn soot sekhar ras may be added for quick and safe response thanks
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Inj Ceftraxazone 1gm BD otherwise Inj Meropenum 500mg BD plus Antispasmodic plus pan 40 Plus ondace 4Mg plus supportive treatments continue

ceftriaxone for 10 days, calculator dose as per weight. plus supportive treatment

Clarithromycin 250 mg BD for 5 days is effective

Typhoid Fever use amaapachak with kaphanashak chikitsa.use laxmivilasa rasa(nardiya) 250mg + anandbhairava rasa 250 mg with honey two times a day after food. to manage high grade fever use godanti bhasma,mrityunjay rasa,amritarishta,cold sponging. advice light diet,milk,fruit juice in diet. watch for constipation

THE TEN DAY COURSE OF CEFEXIME 400 MG DAILY OR TEN DAY COURSE OF AZITHRO 500 MG IS V EFFECTIVE WITH COMPLETE REST MULTIVITAMIN AND GOOD SOFT DIET WITH BOILED OR FILTER WATER S NECESSORY

I agree
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