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High Fever for Two Weeks, Multiple Doctor Visits, Persistent Fever Despite Treatment, Azithromycin, Temperature Normal the Next Day

Male, 25 years old Upper respiratory tract infection-like symptoms, fever for two weeks that did not resolve. He had visited outpatient departments of two hospitals three times in total. One of the outpatient medical records noted: Chief complaint: sore throat for 6 days, accompanied by fever, cough, and expectoration for 2 days Physical examination: pharyngeal congestion, bilateral tonsils enlarged (++), no obvious exudation, heart rate 76 beats/min, clear breath sounds in both lungs The following is a blood routine test report from one visit Department: Internal Medicine Diagnosis: Acute bronchitis Test date: January 15 Report date: January 15 WBC white blood cells 13.1 (4.0-10.0 × 10⁹/L) RBC red blood cells 4.7 (3.5-5.5 × 10¹²/L) HGB hemoglobin 149 (110-160g/L) HCT hematocrit 49.8 (37.0-49.0%) MCV mean corpuscular volume 105.3 (86.0-100.0fl) MCH mean corpuscular hemoglobin 31.5 (26.0-34.0pg) MCHC mean corpuscular hemoglobin concentration 299 (310-370g/L) PLT platelets 147 (100-300 × 10⁹/L) NEUT% neutrophils 45 (50-70%) EO% eosinophils 0.0 (0.5-5.0%) BASO% basophils 0.1 (0.0-1.0%) MONO% monocytes 4.7 (3.0-8.0%) LYM% lymphocytes 10 (20-40%) NEUT# neutrophils 11.1 (2.0-8.0 × 10⁹/L) EO# eosinophils 0.00 (0.05-0.50 × 10⁹/L) BASO# basophils 0.01 (0.00-0.10 × 10⁹/L) MONO# monocytes 0.62 (0.12-0.80 × 10⁹/L) LYM# lymphocytes 1.4 (0.8-4.0 × 10⁹/L) RDW red cell distribution width 47.8 (37.0-50.0%) PDW platelet distribution width 17.1 (9.0-17.0fl) P-LCR large platelets 45.0 (13.0-43.0%) MPV mean platelet volume 12.5 (6.0-12.0fl)


The doctor had prescribed azithromycin, with instructions to take 2 capsules each time, each capsule 150 mg, once daily. This website suggests, only for this case, taking four capsules of azithromycin at one time. Only on that day; there is no need to take azithromycin again the next day. Note that the medication should be taken 2 hours before or after meals. The temperature returned to normal the following day.

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