Dear Doctor, My wife (Age 30 )got a fever 10 days back accompanied by swollen eye brows enlarged lymph node in neck and high tiredness. She is a causality/emergency Medicine junior doctor and she had came in contact in dengue patients during her duty at hospitals where having lot of mosquito .She also had a molar tooth extraction which was impacted and taken out by minor surgery two weeks before this fever .She was on antibiotics after tooth extraction upto one week before the fever onset. She also had take some street food and some juice before two weeks of the fever. She did a blood test on the same day of fever and a NS1 and Igm test which came negative .The blood test was also normal with platelet count of 2.53 and WBC and RBC in normal range. The fever persisted and after 4 days re-tested the blood and the platelets were going down and value was 1.73 with WBC also going down to lower range. The doctor repeated the Dengue test and blood test and the NS1 was negative and the IGM was showing equivocal range of 10.3.The platelet count came down to 1.2 This was around 7th day from the onset of fever On seventh day We got admitted to a more specialist hospital where the physician found palpable spleen enlargement and advised Ultra sound which showed a 15 cm spleen The doctor repeated test for malaria ,Dengue ,Monospot, ect all came negative and the platelets count came to 1.15 .The fever was now down and only two fever spikes of 100. 5F range was noticed and a sample during the fever spike was sent to blood culture. The liver function test shown the liver enzyme level of SGPT 180 SGOT 300 ALP of 249 (.Taken on 8th day from fever) From the day 10 The fever never came back for 72 hours and her blood pressure remained on low side 100/60 mostly .The platelet levels increased to 1.4 from 1.15 .She was not given any antibiotics as the investigation is still on .The only medicine she had was for vomiting sensation ,Paracetamol (only two times during fever spikes) and cough syrup during the hospital stay. The doctor advised as her spleen is enlarged and High ALP with normal liver (under UST) and enlarged lymph nodes. We will wait for the blood culture results and the Typhoid widal result (sample taken on 9th day of fever onset ).They advised for a CT Scan and Bone marrow after they assess the pending test as they couldn't figure out the origin of the symptoms They did a LFT again on 12 th day which had results of SGPT 250 SGOT 495 and Alkaline. Phosphate 254. Slightly elevated from previous result. They did Hepatitis A, B,C,(PT INR) not sure of the name .all came normal. The blood culture report came sterile (taken after 10 days from fever )and the Widal test H antigen value of 1: 320 with O antigen. Today we are waiting to see the physician when he comes on routine visit and get a feed back from him on the widal test as he was on holiday (Sunday) when the result came. Kindly advise 1. Whether the widal test indicate a typhoid (even with I antigen in normal range) 2. Does she need a CT and Bone marrow test. She is still admitted in the hospital and we are bit worried as the fever origin is still undetected and only hope is that it will end up as a typhoid .Kindly pardon me for the mistake in medical terms and revert back if any clarity required as I am a non Medico. Regards,