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Fever consistently at 103 degrees
I have been down with fever since 48 hours and even after taking DOLO 650 three times a day, the fever isn't coming down. It stays consistent in the range of 101-103 degrees.
I have also taken azithromycin 500mg twice a day.
What more can be done?
Answers (20)
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I am Dr Shamoon. A fever that stays fixed in the 101-103 F range for over 48 hours and barely responds to Dolo 650 three times a day needs testing now, not another change of medicine. At 31, in Delhi, and with no other illness or regular medication, the likely causes in this pattern are dengue, chikungunya or another viral fever, typhoid (enteric fever), a urinary tract infection, malaria, or less often scrub typhus or a hidden throat/chest focus. Two things in your history concern me specifically. First, you started azithromycin 500 mg twice daily on your own - that is a higher-than-usual dose, it does not cover most of the causes above, and if this turns out to be typhoid or scrub typhus, a partially treated infection becomes much harder to diagnose and to treat correctly. Second, in dengue the fever often persists exactly like this for 4-6 days and the danger window begins as the fever starts to settle, so blood counts and platelet monitoring matter more than the height of the temperature. Also remember paracetamol only brings the temperature down for 4-6 hours; it does not treat the cause, so incomplete response is expected and is not a sign of treatment failure. Please stop self-medicating with antibiotics and get basic blood tests done today - the results will decide whether you need a specific antibiotic, supportive care only, or admission.
Next Steps
1) Get these tests today: CBC with platelet count, dengue NS1 antigen and IgM, malaria antigen/smear, typhoid (blood culture is best; Widal is unreliable early), urine routine and microscopy, CRP, SGPT/SGOT, creatinine, and a chest X-ray if you have any cough. 2) Stop the azithromycin you started yourself - do not continue any antibiotic without a doctor's assessment and reports. 3) Paracetamol 650 mg may be continued up to a maximum of 4 doses (3 g) in 24 hours, at least 4-6 hours apart; add tepid sponging of the forehead, neck, armpits and groin when the temperature crosses 102 F. 4) Avoid ibuprofen, diclofenac, aspirin, nimesulide or combination pain-fever tablets until dengue is ruled out - they increase bleeding risk. 5) Drink 3-3.5 litres of fluids daily (water, ORS, coconut water, soups, buttermilk) and take light, easily digestible food; monitor that you are passing urine at least every 4-6 hours. 6) Record your temperature every 4 hours and note any rash, joint pains, severe headache, eye pain, vomiting, burning urine or loose motions - carry this chart to the doctor. 7) Repeat the platelet count daily for the next 3 days if dengue is positive or suspected. 8) Get examined in person today or tomorrow rather than treating this over the phone. You are welcome to consult me here on Practo to review your reports, or in person at Synergy Multispeciality Hospital, Miraj.
Health Tips
Word of caution: go to a hospital immediately if you develop bleeding from the gums, nose or in vomit/stool, red spots on the skin, severe abdominal pain, persistent vomiting, black stools, breathlessness, cold clammy hands, giddiness on standing, reduced urine output, drowsiness or confusion, neck stiffness, or if the fever crosses 104 F or continues beyond 5 days. Do not exceed 4 g of paracetamol in 24 hours, avoid alcohol, and do not take steroids or repeated antibiotic courses on your own.
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Any associated complian like chills, sore throat, ??
Kindly contact me for the best treatment 😊
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It could be a viral fever.Dolo 650 may not be adequate, you may need additional analgesic.Azithromycin is not taken twice daily
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Most Likely It's Of Bacterial Origin.If You Share Other Symptoms Associated With Fever,It Will Be Helpful.Just Taking Azithromycin Will Not Slove Any Disease Like Magic.You Have To Appropriate Antibiotic For Specific Disease.For That You Must Share Detailed History.
Thank You.
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Stop dolo
ADD ZERODOL SP3 TIMES A DAY AFTER FOOD FOR 3TO5 DAYS.
AZITHRO DOSE 500 ONCE A DAY.
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For a detailed discussion regarding your concern, please feel free to contact me on WhatsApp at
nine zero four four five one one two nine nine.
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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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Fever with high grade intensity.....
Most likely possibilities is viral fever
But it has been since more than 48 hours..if need to be evaluated.....
Investigation
1) Complete Blood Count
2) NS1 Antigen
3) IgM & IgG Antibodies
4) PS Malaria Parasite
5) WDAL
6) Blood culture
Treatment
Plenty of fluids
ORS ( orally Rehydration salt)
Keep dehydrated
Tab Dolo 625 mg 6 hourly if needed
Tab Azithromycin 500 mg already Taken
But not Twice a day it should be once a day...
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Tab dolo 650 is not sufficient for fever at 101-103 consistent. You need to be inj.pcm 1gm iv for fever control and tab dolo 650 sos and cold sponging over body. Get the dengue ,typhoid,malaria,cbp with platelet count tests done. And don't use antibiotics unnecessarily coz tab azax 500 once daily is sufficient. It causes unnecessary load on kidneys and liver. Get tests done. Stay hydrated. Dont use pain killers
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Instead of dolo650, you can take paracetamol 500mg every 4 to 6 hours, do tepid water sponging, drink more water.
Get cbc, typhidot, tests for malaria, dengue, done and share results.
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kindly do connect and consult with me for better treatment plan and advice on your case via PRACTO app
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Go for blood test now first to ruled out infection.
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Need further evaluation
Please connect for guidance
Will try our best to help you
Next Steps
blood test
cbc
fever profile
Health Tips
take proper rest
maintain hydration
cold water sponging
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Please do a blood test cbc crp and dengue virus test
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Requires a proper assessment to understand the underlying cause and guide you.
Please book a consultation for a detailed evaluation, personalized treatment plan and further advice.
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Dr. Rohan Gumber
General Physician
1 yrs exp
Sri Ganganagar
If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at eight six one nine six six nine nine zero six. Alternatively, you can connect with me through the Practo app for a detailed consultation
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Ashita Kuruvilla
General Practitioner
8 yrs exp
Kolkata
Need few more details for further evaluation. Please consult
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Do connect and consult
Will help you
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Dr. Anuj Mothsra
General Practitioner
7 yrs exp
Jhunjhunu
Can help you , kindly consult and provide detailed history for proper diagnosis and further management
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