The case study details a 40-year-old female patient diagnosed with typhoid fever, presenting symptoms of persistent fever, abdominal pain, and burning micturition. Laboratory tests confirmed the diagnosis, and a treatment regimen involving paracetamol, ceftriaxone, metronidazole, and ranitidine was prescribed. Patient counseling emphasized avoiding contaminated food and water, regular handwashing, and the importance of maintaining hygiene to prevent further infections.

1. • CASE STUDY BASED ON DISEASE
• TYPHOID {ENTERIC FEVER}
PREPARED BY
MARTIN SHAJI
PHARM D

2. • Patient name –Ms. x OP no. –163008
• Admission date- 30-2- 19
• Age-40
• Sex-f
• Department- General medicine.
PATIENT DEMOGRAPHY

3. 1. Physical examination: patient conscious and coherent
Vital signs:
Temperature (oF): 101
Pulse rate (/min): 78beats
Blood Pressure (mm of Hg):120/80mm of Hg
2. Systems Examination:
CVS: S1, S2 +
RS: Clear
GENERAL EXAMINATIONS.

4. CHIEF COMPLAINTS
Persistent fever for few days at frequent intervals with abdominal pain. In addition to
pain burning micturition .
PAST MEDICAL HISTORY
Nothing significant.
ALLERGY :(food/drug/other)
No known allergies.
PERSONAL HISTORY AND HABITS:
Diet: Mixed
Sleep: abnormal.
FAMILY HISTORY:
Nothing significant.

5. LAB INVESTIGATIONS
• Renal function test
• Blood urea – 18 mg/dl
• Serum creatinine-1. mg/dl
• Uric acid -4.3IU/dl
• RANDOM BLOOD SUGAR- 108mg/dl
• WBC -12,000cells/cu.mm
• ESR – 32mm/hr
• WIDAL TEST
• S. typhi “o” -1:80/dilution
• S. typhi “H”-1:20/dilution

6. SUBJECTIVE EVALUATION
A 40 years old lady patient was consulted with the complaints of persistent
fever for few days at frequent intervals along with abdominal pain, burning
micturition .
OBJECTIVE EVALUATION
On Examination, the patient was conscious & coherent. Lab data reveals
slight elevation in WBC- 12,000cells/cu.mm and ESR about 32, widal test
shows positive dilutions
ASSESSMENT:
Based on subjective & objective evaluation the physician
confirmed it as enteric fever {typhoid fever}
SOAP NOTES

7. CONFIRMATOR
Y
DIAGNOSIS
THYPHOID {ENTERIC FEVER}

8. Sl.N
o.
Drug
Indication ROA Frequency and dose.
Brand Name Generic Name
1.
T.PCT PARACETAMOL
ANTIPYRETIC
&ANALGESIC ORAL 500MG TID/ 4 DAYS
2. INJ .CEF CEFTRIAXONE ANTIBIOTIC IV
1MG BID/ 4 DAYS
3. METRONIDA
ZOLE
METRONIDAZOLE ANTIBACTERIAL
ORAL 500MG BID /3 DAYS
4. RANTAC RANTIDINE H2-BLOCKER
ORAL 25MG TID/4 DAYS
DRUG CHART

9. ON DAY 1 – 4
Ranitidine
25mg BD is used as an anti-ulcerative drug which reduce stomach irritation ,donot take
more than two weeks given for 4 days .
Paracetamol
650mg BID is used as an anti-pyretic. It act as a pain killer and also as temp lower. Given
for 4 days
Inj. Ceftriaxone
1mg ceftriaxone IV bid is used as an antibiotic injection . Which fight against the infection.
Given for 4 days.
METRONIDAZOLE
500mg BID oral is given as an antibacterial . Given for 3 days .
REGARDING MEDICATION

10. PHARMACIST INTERVENTIONS
1. The prescription was rational.
2. No DDI or ADRs were found

11. PATIENT COUNSELING- Instructions for patient
•Drink only boiling water as heat kills as many germs as possible. ...
•Avoid eating outside food, especially salads and wet dishes because if the
vegetables or meat used are washed with contaminated water, it can lead to
typhoid.
•Wash your hands. Frequent hand-washing in hot, soapy water is the best way
to control infection. ...
•Avoid drinking untreated water. Contaminated drinking water is a particular
problem in areas where typhoid fever is endemic. ...
•Avoid raw fruits and vegetables. ...
•Choose hot foods

12. DISCUSSION
Typhoid is a bacterial infection that can lead to a high fever, diarrhea,
and vomiting. It can be fatal. It is caused by the bacteria Salmonella
typhi. The infection is often passed on through contaminated food and
drinking water, and it is more prevalent in places where hand washing
is less frequent.
Typhoid fever is an infection that spreads through contaminated food and
water.
Vaccines are recommended in areas where typhoid fever is common.
Symptoms include high fever, headache, stomach pain, weakness, vomiting
and loose stools.
Treatment includes antibiotics and fluids.