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Continuous fever
My wife has been having a fever (102.6) since yesterday evening which runs after every 4 hrs. She has taken Dolo 650 3 times, still the situation remains the same.
Kindly advise medicine.
Answers (42)
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If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at nine one one nine two five five six nine nine. Alternatively, you can connect with me through the Practo app for a detailed consultation
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A fever of 102.6 F that keeps coming back every 4 hours on the first day or two is very typical of a viral fever, and it is normal for paracetamol to bring it down only for a few hours - that does not mean the medicine has failed. Please continue paracetamol 650 mg every 6 hours (maximum 4 doses in 24 hours), and in between do tepid sponging with normal room-temperature water on the forehead, neck, armpits and groin, which brings the temperature down faster than any tablet. Give plenty of fluids - water, ORS, coconut water, soups, thin dal - and light food and rest. Please do not add any antibiotic on your own and avoid ibuprofen or combination painkillers until dengue is ruled out, as they can worsen bleeding. Since it is now the second day, if fever continues beyond 48-72 hours, get a CBC with platelet count, dengue NS1 and IgM, malaria smear or rapid test, urine routine and a CRP done, and see a doctor with the reports - in Delhi at this time dengue and typhoid both need to be excluded. Please take her to a hospital immediately if she has breathlessness, chest pain, persistent vomiting, severe abdominal pain, bleeding from gums or nose, red spots on skin, black stools, very little urine, drowsiness, confusion, seizures, cold clammy hands or a fever above 104 F not responding at all. You are welcome to consult me on Practo for follow-up, or bring her to Synergy Multispeciality Hospital, Miraj if you are nearby.
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This is more likely viral fever which is spread in rainy season
Next Steps
Teppid sponging along with PCM -500mg thrice a day
Multivitamin once a day
Do some lab test if fever not subside in 2 days
Lab test like
CBC
Widal test
M parasite
Health Tips
If any other symptoms along with fever like shivering,joint pain ,nausea consult to me on practo ..instant consult
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Continue dolo 650.
Do tepid sponging.
Maintain hydration with atleast 2.5 litres water daily.
Next Steps
Run some tests:-
CBC
Dengue NS1 and IgM
Typhidot IgM
MP test
Health Tips
Come back with results and consult me on practo for further management.
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Cbc crp esr
Tab zerodol sp three times after food for 3to5 days
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Paracetamol can only for 4 hours, in some upto 6 hours only. It's better find out cause for fever and then treating the root cause.
Try mefenamic acid with paracetamol combination for time being for fever. (If she is not allergic to mefenamic acid)
Needs further details for proper diagnosis and management
Next Steps
feel free to consult me on practo for further evaluation and management
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A high fever at this time of the year needs a thorough fever panel check . You should get tested for dengue , typhoid , influenza A, malaria ,and cbc .
Next Steps
Follow up with reports
Health Tips
For time being untill u get tested for the fever panel , dolo 650 mg round the clock , every 6 hours, will help keep the fever down . As soon as we get the reports we can start you with antibiotics and further treatment
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Don’t afraid this is season for viral fever and you take dolo 650 6-8 hourly and give her ors and electoral solution for preveting dehydration
If fever comes with chills and rigours then you should go for some test like cbc, malaria antigen test
If you want to consult me take any platform practo or WhatsApp
Next Steps
Do not take unnecessarily antibiotic this create resistance to body and harm body take when needed only
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Hello , What else symptom she has other than fever ? Is chills , rigors , Headache, loose stools , Abdominal pain , vomiting present ? If she feels extremely weak , dizziness and not manageable at home , do not let it worsen , kindly visit nearby hospital for the same , as the underlying cause of fever needs to be evaluated. Only symptomatic treatment with Antipyretics and other medicines will not be beneficial.
Next Steps
She should drink plenty of water and liquids .
Health Tips
Do not give dose of Paracetamol more than 4 grams in 24 hours
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She may have an underlying focus of infection that warrants further evaluation. A detailed clinical history, thorough physical examination, and appropriate investigations are recommended to identify the source and guide further management. Consultation is advised for comprehensive evaluation and appropriate treatment
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A high fever of 102.6°F recurring every 4 hours means her immune system is actively fighting an infection (most commonly an acute seasonal viral illness or upper respiratory infection). Dolo 650 (paracetamol) is an antipyretic—it resets the body’s temperature temporarily for about 4 to 6 hours, but it does not cure the root cause. Once the effect wears off, the fever naturally rebounds until the underlying infection begins to resolve.
Next Steps
Consult for Clinical Evaluation: If the fever continues into a second or third day without easing, consult a doctor online or in person to identify the focus of infection. A basic blood test (such as a Complete Blood Count) may be required.
Watch for Red Flags: Seek immediate in-person emergency care if she develops severe shivering/rigors, persistent vomiting, shortness of breath, severe abdominal pain, a new skin rash or extreme drowsiness.
Avoid Blind Antibiotics: Do not start over-the-counter antibiotics or non-prescribed pain relievers without a doctor's evaluation.
Health Tips
Safe Dosing Limits: Maintain a strict gap of at least 4 to 6 hours between Dolo tablets. Do not exceed 3 to 4 tablets (maximum 2,600 mg) in 24 hours to protect the liver.
Tepid Sponging: If the temperature rises above 101°F despite medication, sponge her forehead, neck, and underarms using normal tap water. Avoid ice-cold water as it causes shivering and increases internal core temperature.
Hydration: High fever causes rapid fluid loss. Encourage frequent sips of ORS, coconut water, clear broth and plain water throughout the day.
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A high-grade fever recurring every 4 hours that is refractory to paracetamol (Dolo 650) suggests a potentially robust inflammatory or infectious etiology that warrants formal physical examination and diagnostic evaluation rather than empirical dose escalation.If you could tell symptoms others than Fever ,this could help differentiating the etiology And causes.Avoid self-prescribing additional antipyretics or combining NSAIDs (such as ibuprofen) without clinical guidance, as frequent dosing intervals or compounding analgesics increase the risk of hepatotoxicity, gastrointestinal irritation, or renal compromise.
Next Steps
Schedule an immediate consultation with a general physician.
Health Tips
Maintain adequate oral fluid intake to prevent dehydration from recurrent high temperatures and keep a strict log of temperature spikes and medication timings.
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Please go to the hospital and do CBC,CRP,dengue test and Malaria test and take Iv fluids
Keep cold compress on forehead
Don’t eat oily fried food
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Continue Dolo 650 mg 3 times a day, with adequate oral fluids/ORS and rest. If the patient is having any other symptoms connect with me for further assessment, investigations and medicines.
Next Steps
If the fever persist more than 1 week consider doing some investigations ( CBC with ESR , LFT , RFT, Urine RE/ME , NS1 antigen , IgM Thyphoid , PBS for malaria.
Health Tips
Visit a nearby hospital immediately if the patient develops warning signs such as persistent vomiting, severe abdominal pain, bleeding, breathlessness, altered sensorium, poor oral intake or reduced urine output.
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It may be viral or seasonal fever so if u r giving dolo then continue it and if temp goes beyond 100 then give her cold sponging it will help her temp to decrease. Then do some tests and consult for further evaluation.
Next Steps
do some tests like cbc, dengue ns1 antigen test and consult for further evaluations......
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Dengue , malaria and flu are very common in rainy season.
She need evaluation for such high grade fever and blood test like CBC, ESR, dengue NS1 , PS for MP , CRP
Next Steps
Kindly book an appointment on Practo, for full detailed evaluation and treatment..
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