* BANGLADESH MAN ASKS WHY HE HAS FEVER FOR MONTHS AT A TIME?
"Dear sir, can I talk to you???
Can you suggest
me some advice to be safe from fever??? In
a year, i suffer from fever a lots of time like 3-5 month with isolated period.
But this sickness keeps me always weaker than everyone, I want to be healthy.
Plz.. Help me Ok...! Till then I will
wait for you." ("JRahm", Bangladesh)
Dear "JRahm,"
I am glad we were able
to visit on Facebook, 2016 Thanksgiving weekend, as your question revolves
around trying to locate a fever of unknown origin. We doctors try to narrow the source of a fever
to the following, four general classes:
human immunodeficiency virus- related (HIV), immunocompromised related,
classic, and nosocomial; thus, my questions were directed to target the most
likely possible source of your fever.
Your original statements, " I'm from Bangladesh. Fever could me almost 3-4months of an year
on different spell," along with telling me you were hospitalized "It
was for typhoid. I was hospitalized on
almost a year ago, that's the reason," spoke volumes of information. Specifically, your fever falls in the
"classic" category. A classic
fever is a fever of at least 100.9F or higher, a fever with a duration of
greater than three weeks, and a fever requiring an evaluation of at least three
outpatient visits or three days in the hospital. However, when I asked how long were you in
the hospital, you said " Just 2days."
Technically, the fact that you were in the hospital only two days places
you outside the classic fever category; however, I do believe, your timeline of
events might lend an explanation as to why you have had "3-5 months" of fever after hospitalization.
Let me
explain. When I asked you what
medication did the hospital provide, you said, " I can't remember, and the
prescription has run out." Salmonella
typhi is a gram negative bacterium that causes typhoid fever in humans. Typhoid fever is a disease marked by the
following symptoms not limited to prolonged fever, nausea, diarrhea, fatigue,
headache, low energy, stomach pain, or sore
throat. The drug of choice to
treat typhoid fever is Ciprofloxicin or Ceftriaxone, both of which are provided to a patient over two weeks. Other medications that have proven effective
against typhoid fever include amoxicillin and
trimethoprim-sulfamethoxazole. There
exist over 100 different strains of Salmonella typhi; thus, resistance of this
bacteria is common to many antibiotics.
In other words, many antibiotics are not effective in killing the
Salmonella typhi. Although you tried
your best to remember details of your typhoid fever treatment, two items became
clear to me about you, 1) possibly, the correct antibiotic may not have been
chosen to kill the Salmonella bacteria or 2) the antibiotics prescribed may
have been correct; however, the duration of treatment may not have been long
enough. Therefore, the Salmonella typhi
may still be abundant in your bloodstream, causing the "3-4months of an year" fever.
Remember, the
most common source of infection, in acquiring typhoid fever, is water
contaminated by the urine and feces of infected individuals; thus, if possible,
as a means to prevent transmission, drink bottled water or boil local water
sources prior to ingestion. Furthermore,
once the boiled water has cooled, wash fruits and vegetables in that cleaned
water, and ALWAYS WASH YOUR HANDS
repeatedly throughout the day. Typhoid
fever is treatable and reversible; however, when the Salmonella typhi bacteria
is not killed, a person becomes a carrier and a likely transmitter of infection
to other people.
My
recommendation is for you to revisit the hospital personnel, requesting blood
work to identify if Salmonella typhi still exists in your blood. If confirmed, the hospital should be able to
run tests that would determine which antibiotic(s) is/are effective to kill
those strain(s) of bacteria in your body.
Thank you for
your question and trust in my opinion.
Please stay in touch as I wish to know the outcome of hospital
tests. In the meantime, thanks for your
compliments and peaceful prayers. God
Bless you and God Bless Bangladesh.
Respectfully,
Dr. Roshin
*
