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Typhoid/UTI- Lymphocyte 70,Neutrophil 25
I am suffering from typhoid and diarrhoea from more than one and half months which got diagnosed 20 days back. Yesterday, I got diagnosed my urine test done since I was feeling itching & burning sensation. Urine RBC is 2-3 & epithelial cells is 25. I am worried about the sudden change in my blood profile. Last week Neutrophils were 58 and today 25. Last week Lymphocyte were 37 and now 70. Platelets reduced from 1.60 to 1.10. ESR from 11 to 20. I have been taking cefixime & ofloxacin for typhoid but struggling with dehydration due to diarrhoea. Kindly suggest and help with your opinion. Thank you!
Your blood tests are a result of the ongoing infection.
Continue the antibiotics as recommended.
Take plenty of ORS and fluids.
Even then if you are have itching and burning, repeat urine routine and get culture sand sensitivity of urine done.
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Chronic diarrhoea with salmonella is a risky combination. Reversal of N:L ratio in this can be a sign chronic infection. Salmonella for more than 4 weeks and cause AKI and TID, in that situation epithelial cells can be found on urine routine examination. Raised ESR and thrombocytopenia can be secondary to ongoing inflammatory reaction.
Next Steps
Since things can complicate further, the most dangerous being bowel perfortaion, I'd suggest to get admitted and rehydration acc to fluid deficit protocols. Get complete blood electrolytes checked, abdominal imaging may be required. Antibiotics should be stepped up. I'll personally recomment parenteral Ceftriaxone with Azithromycin combination.
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