Tuesday, September 13, 2011

Fever, fever and fever. . . .

Over the last couple of weeks, we have been having patients galore with fever of all types. Of course, most of them have already had treatment elsewhere, especially with the quacks about whom you can read here.

The majority of them do not test positive for anything except for a few who will have features suggestive of septicemia in their blood picture. Very few of them show the malaria parasite in their smear - and most of them who have a falciparum positive picture would have come straight to us.

Over the last many years I know of this place – there have been only two diagnosis – malaria or enteric fever. One of my colleagues here has the following different diagnosis for all sorts of fever. Malaria, probable malaria, chronic malaria, resistant malaria, recurrent malaria etc. He does not believe that there can be any other diagnosis.

We are looking at the options of being part of looking at the various causes of fever in this part of the country. Couple of weeks ago we had an epidemic of fever of which couple of them had tested to be CSF positive for bacterial meningitis. Almost all of them were only responding to either erythromycin or azithromycin and we had assumed that H.influeza must have been the cause.

I’m sure that if we do a study, we’ll find quite a number of new viruses and there is high possibilities of finding leptospirosis. Dengue has already been documented last year. Chikungunya has already been documented in our nearby districts. We had one typical case in the OPD last week. However, unless we do a systematic study we would not able to find the cause.

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