A 52-year male having high-grade fever since 10 days, not controlling with routing paracetamol. Vital is normal. Rashes have seen all over the body. Blood c/s shows Xanthomonas or Pseudomonas, confused microbiologist. Antibiotic resistance to all. The total count is the 4 th day of fever was 12700, 6 th day 16000, 7 th day is 140000 and 8 th day is 18000.
The patient was referred from district hospital where Hepatitis E was positive. In Higher centre retest was done which is negative. Bilirubin is higher side, SGPT is 800. Gastro-intero physician suspected scrub typhus and giver doxycycline and ciprofloxacin. How to treat this patient and where to refer?
