Day 1- Patient X has fever for a day in the range of 99-102 degree F. Symptoms are Shivering off an on but not wrapping a blanket kind.
X wants fans to be switched off, has taken a dose of Paracetamol and retained it. Fever has come down but only a bit.
No Cough,No abdominal distention, No vomiting ( slight nausea and loss of appetite)
O/E- Chest is clear.
Throat shows no inflammation.
X looks dehydrated and his lips are dry.
X is panicky because of Scare created about Zika, Swine Flu, Meningitis or some other deadly fever.
May be X is watching too many scary News on TV.
Should we send X for investigations?
Will Tests for bacterial diseases like Typhoid /Viral diseases like Dengue, Chikungunya,Zika, Swine Flu, Flu/Parasitic diseases like Malaria Be Positive on Day 1 of Fever ??
No, Just watch for symptoms till Day 3 of Fever of Unknown Origin-
Paracetamol 500 for healthy adult , every 8 hourly if awake.
Add an Anti Allergic Tablet like Phenergan. Besides giving relief from elements of Allergy present in Humid Air, It relieves the Symptoms of Restlessness also.
Total Bed Rest till full Cure-one week minimum.
Light liquid Nourishment only with lots of diluted toned milk, clear soups and lots of ORS type of liquids like homemade lemon juice+ honey in 1 L water/ lots of sachets in market with different flavors.
No upper limit for ORS Therapy.
If digestive system is loaded with heavy food like routine daal-roti-chawal subzi & fried Non Veg items, body uses up more energy to digest food making recovery a difficult and prolonged. or sponging.
Wear only cottons as synthetics absorb heat in the environment and germs are recycled causing autoinfection to self and to others.
General Hygiene to be maintained by bathing.
Day 2- X is better but fever stays.
Should a blood test be done?
Should antibiotics be given?
Not yet- Observe till ---
If fever stays, get Widal test to rule out Typhoid.
Get Platelet counts/ CBC done. Hb may be lower during fever but total counts will give an idea about bacterial infections.
Remember that in Typhoid Fever the Total Counts are in the Lower Range. And we can Depend upon Widal Test specific for Typhoid by now.
Platelet Counts if in the range of 1-2 Lakhs rules our Dengue.
No need to get Specific Antigen Tests for Viral Fevers because these become positive by day 7 and cost more money too.
Antibiotics can be started if
Total Counts are High suggesting a bacterial infection anywhere in the body &
Widal Test is Positive.
Viral Fevers and other fevers take about a week to get cured if care is taken in Toto.
Otherwise these diseases make admissions to overcrowded hospitals a Must.
Remember to Take 2 Tablets of Sugar coated Chloroquine every week as Prevention of Malaria.
Weekly Dose of 2 tablets carry No Harm.