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Fever Package

Bacterial/ Viral

64 parameters

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Report in 24Hrs

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At Home

fastingrequire

Fasting Required

Details

Comprehensive fever profile check for cause - Malaria, Dengue, Typhoid; liver, blood, urine

₹1,399₹2,500

44% OFF

Parameters

  • List of Tests
    • Urine Complete (18)
    • Smear for MP (Malarial Parasite)
    • ESR
    • Liver Function Test (11)
      • Albumin
      • Alkaline Phosphatase
      • Bilirubin - Direct
      • Bilirubin - Indirect
      • Bilirubin - Total
      • AST/SGOT
      • ALT/SGPT
      • Total Protein
      • A/G Ratio
      • Gamma GT
      • Globulin
    • Widal Tube Test (24H)
      • Salmonella Typhii - O/H Antigen
      • Salmonella Paratyphi A-H/B-H Antigen
    • Dengue NS-1 Antigen (ELISA)
    • CBC - Complete Hemogram (28)

Fever Package - Comprehensive Diagnostic Guide

  • Why is it done?
    • Comprehensive evaluation of fever of unknown origin (FUO) to identify underlying infectious or systemic causes
    • Detection of common tropical infections endemic to many regions, particularly malaria, dengue, and enteric fever
    • Assessment of complete hemogram to evaluate for anemia, infection markers, platelet abnormalities, and white blood cell changes associated with fever
    • Evaluation of liver function to detect hepatic involvement in systemic infections or fever-related complications
    • Detection of urinary tract involvement through urinalysis, which may indicate urinary tract infection or systemic illness manifestations
    • Measurement of inflammatory markers (ESR) to assess severity and chronicity of infection or systemic inflammation
    • Systematic approach combining parasitological, serological, and hematological investigations for rapid differential diagnosis
    • Ordered when patient presents with fever lasting more than 3-5 days, or when fever pattern suggests specific tropical infections
    • Particularly useful in endemic areas or for travelers returning from tropical/subtropical regions with fever symptoms
  • Normal Range
    • Urine Complete (18): Appearance - Clear; Color - Pale to dark yellow; Specific gravity - 1.005-1.030; pH - 4.5-8.0; Protein - Negative/Trace; Glucose - Negative; Ketones - Negative; Bilirubin - Negative; Urobilinogen - 0.1-1.0 mg/dL; Nitrites - Negative; Leukocyte esterase - Negative; RBCs - 0-3/hpf; WBCs - 0-5/hpf; Epithelial cells - 0-5/hpf; Casts - 0-2/lpf; Bacteria - None/Rare
    • Smear for MP (Malarial Parasite): Negative - No malarial parasites observed in blood smear under microscopy
    • ESR (Erythrocyte Sedimentation Rate): Males - 0-15 mm/hour; Females - 0-20 mm/hour; Above 20 mm/hour suggests infection or inflammatory process
    • Liver Function Test (11): Total Bilirubin - 0.1-1.2 mg/dL; Direct Bilirubin - 0.0-0.3 mg/dL; Indirect Bilirubin - 0.2-0.9 mg/dL; AST/SGOT - 10-40 U/L; ALT/SGPT - 7-56 U/L; Alkaline Phosphatase - 30-120 U/L; Total Protein - 6.0-8.3 g/dL; Albumin - 3.5-5.5 g/dL; Globulin - 2.3-3.5 g/dL; A/G Ratio - 1.0-2.5; Gamma GT - 8-61 U/L
    • Widal Tube Test (24H): Negative - Agglutination titer <1:40 for all antigens (O and H antigens of S. Typhi and S. Paratyphi A/B)
    • Dengue NS-1 Antigen (ELISA): Negative - Absence of dengue NS-1 antigen; Positive - Presence of dengue NS-1 antigen indicating acute dengue infection
    • CBC - Complete Hemogram (28): Hemoglobin - Males 13.5-17.5 g/dL, Females 12.0-15.5 g/dL; RBC Count - Males 4.5-5.9 x 10^6/μL, Females 4.1-5.1 x 10^6/μL; WBC Count - 4,500-11,000/μL; Platelets - 150,000-400,000/μL; MCV - 80-100 fL; MCH - 27-33 pg; MCHC - 32-36 g/dL; Hematocrit - Males 41-50%, Females 36-46%
  • Interpretation
    • Urine Complete: Presence of protein, RBCs, WBCs, or nitrites suggests urinary tract infection or systemic involvement; Presence of casts indicates renal involvement; Abnormal pH or specific gravity may indicate dehydration or metabolic issues
    • Smear for MP: Positive results indicate malaria; Species identification (P. vivax, P. falciparum, P. malariae, P. ovale) determines treatment approach; Parasite load percentage correlates with disease severity; Multiple negative smears over 48 hours help rule out malaria
    • ESR Elevated: >20 mm/hour suggests ongoing infection or inflammation; Very high values (>50 mm/hour) indicate severe infection, chronic inflammation, or malignancy; Mild elevation with other symptoms helps support diagnosis of infectious disease
    • Liver Function Test - Elevated AST/SGOT and ALT/SGPT: Indicates hepatocellular injury; ALT elevation greater than AST suggests viral hepatitis; Both elevated equally suggest viral infection or sepsis; Ratio >2 suggests alcoholic or drug-induced liver injury
    • Liver Function Test - Elevated Bilirubin: Direct bilirubin elevation suggests cholestasis or biliary obstruction; Indirect bilirubin elevation indicates hemolysis or hepatic dysfunction; Combined elevation with elevated transaminases confirms hepatic involvement
    • Liver Function Test - Low Albumin: <3.5 g/dL indicates chronic liver disease, malnutrition, or acute systemic illness; Low A/G ratio suggests liver dysfunction
    • Widal Tube Test - Positive Results: Titer ≥1:40 suggests typhoid fever; Rising titers on repeat testing (paired sera) more diagnostic than single high titer; O antigen positivity with negative H antigen suggests early infection; Both O and H positive indicate established infection; Paratyphi A/B positivity indicates paratyphoid infection
    • Widal Tube Test - Limitations: Previous vaccination or infection may cause false positives; Single positive result must be correlated with clinical findings; Sensitivity is low in early disease (first week)
    • Dengue NS-1 Antigen: Positive result indicates acute dengue infection (most accurate in first 5 days of illness); Sensitivity is 95-98% in primary dengue and 80-90% in secondary dengue; Negative result does not exclude dengue, especially after 5 days when IgM antibodies may be detected instead
    • CBC - Elevated WBC Count: >11,000/μL indicates bacterial infection or leukemia; Left shift (increase in immature WBCs) suggests acute bacterial infection; Marked elevation (>50,000) raises concern for leukemia or severe infection
    • CBC - Low WBC Count: <4,500/μL suggests viral infection, bone marrow suppression, or drug effects; May indicate dengue hemorrhagic fever in dengue patients
    • CBC - Low Platelet Count: <150,000/μL may indicate dengue, malaria, or sepsis; <50,000/μL poses risk for spontaneous bleeding; Thrombocytopenia with low WBC suggests dengue hemorrhagic fever
    • CBC - Anemia: Low hemoglobin and hematocrit may indicate chronic infection, hemolysis, or bone marrow involvement; Combined with low platelets suggests malaria or dengue
  • Associated Organs
    • Urine Complete: Evaluates kidneys and urinary tract; Detects pyelonephritis, urinary tract infection, glomerulonephritis, and acute kidney injury; Can reveal systemic manifestations affecting renal function in fever-related illnesses
    • Smear for MP: Evaluates blood parasites; Detects Plasmodium species causing malaria; Complications include cerebral malaria, pulmonary edema, acute renal failure, and severe anemia
    • ESR: Reflects systemic inflammation affecting multiple organ systems; Elevated ESR indicates inflammatory response that may affect vascular endothelium, organs, and tissues; Non-specific but useful indicator of disease activity
    • Liver Function Test: Evaluates hepatic function and integrity; Detects viral hepatitis, hepatic involvement in typhoid fever, sepsis, and liver abscess; Complications include hepatitis, liver necrosis, cirrhosis, acute liver failure, and disseminated intravascular coagulation
    • Widal Tube Test: Evaluates immune response to Salmonella typhi and paratyphi; Detects typhoid fever and paratyphoid fever; Complications include intestinal perforation, myocarditis, encephalopathy, and multiorgan failure in untreated cases
    • Dengue NS-1 Antigen: Evaluates viral antigen in blood; Detects acute dengue infection; Complications include dengue hemorrhagic fever, dengue shock syndrome, hepatomegaly, thrombocytopenia, and bleeding manifestations affecting multiple organs
    • CBC - Complete Hemogram: Evaluates hematopoietic system (bone marrow, blood cells); Reflects overall systemic health and immune response; Detects infections, bone marrow disorders, anemia, leukemia, and bleeding disorders; Complications include severe anemia requiring transfusion, severe neutropenia with opportunistic infections, and bleeding from thrombocytopenia
  • Follow-up Tests
    • If Urine Complete is abnormal: Urine culture and sensitivity for confirmed urinary tract infection; Renal ultrasound to evaluate kidney structure; 24-hour urine protein quantification for proteinuria; Serum creatinine and BUN for renal function assessment
    • If Smear for MP is positive: Repeat smears at 12, 24, and 48-hour intervals to confirm diagnosis and assess parasite density; Species identification through Giemsa staining expertise; Quantitative buffy coat for parasite density; PCR for malaria if available for definitive species identification; Blood glucose, lactate, and arterial blood gas for severe malaria assessment
    • If ESR is elevated: Repeat ESR after 2-4 weeks to assess response to treatment; C-reactive protein (CRP) for more specific inflammatory marker; Autoimmune panel if ESR persistently elevated without clear infection
    • If Liver Function Tests are abnormal: Viral hepatitis serology (HAV, HBV, HCV antibodies and antigens); Prothrombin time (PT) and INR for synthetic liver function; Liver ultrasound to assess structure and rule out abscess; Blood culture if sepsis suspected; Repeat LFTs after 1-2 weeks to assess trend
    • If Widal Tube Test is positive: Blood culture for definitive diagnosis of typhoid; Repeat Widal test after 7-10 days (paired sera) to look for rising titers; Stool culture during convalescence; Serum antibodies to Salmonella typhi Vi antigen for chronic carrier detection; CT abdomen to assess for complications like perforation
    • If Dengue NS-1 is positive: Dengue IgM and IgG antibodies (ELISA or rapid tests) for serological confirmation; Repeat NS-1 or IgM testing after 3-5 days if initial test done very early; Platelet monitoring at 24-48 hour intervals during acute phase; Hematocrit serial measurements to assess for plasma leakage (>20% rise suggests dengue hemorrhagic fever); Liver enzymes and coagulation profile for severe dengue manifestations
    • If CBC is abnormal: Differential white blood cell count breakdown if not provided; Reticulocyte count if anemia present; Iron studies, B12, and folate levels if anemia or macrocytosis noted; Bone marrow aspiration and biopsy if marked cytopenias or suspected leukemia; Coagulation studies (PT, aPTT) if bleeding tendency noted
    • General Follow-up Recommendations: Repeat Fever Package after 5-7 days if initial tests negative but high clinical suspicion; Blood culture in all febrile patients suspected of sepsis; Chest X-ray if respiratory symptoms present; Abdominal ultrasound to assess for splenomegaly, hepatomegaly, or abscess formation; ECG if cardiac involvement suspected
    • Monitoring Frequency: For confirmed infectious disease, recheck CBC, ESR, and specific pathogen markers weekly during acute illness; For resolved infection, follow-up tests at 2-4 weeks to confirm resolution; For chronic infections, monitoring as per treatment protocol and specialist recommendations
  • Fasting Required?
    • Fasting Status: YES - Fasting is required for accurate results, specifically for Liver Function Tests
    • Fasting Duration: 8-12 hours overnight fasting preferred; minimum 6 hours fasting acceptable; water intake is allowed during fasting period
    • Timing: Blood collection should ideally occur in the morning (7-9 AM) after overnight fasting for consistent and accurate liver function parameters and lipid profiles if needed
    • Medications: Continue all essential medications (blood pressure medications, cardiac medications, diabetes medications) unless specifically advised otherwise by physician; do not discontinue medications without medical consultation
    • Dietary Restrictions: Avoid all food and beverages except water for 8-12 hours before blood collection; avoid alcoholic beverages for 24 hours prior to testing; avoid heavy or fatty meals the night before collection
    • Physical Preparation: Avoid strenuous exercise for 24 hours before testing; ensure adequate rest the night before collection; be in a calm, relaxed state during blood collection; inform phlebotomist of any medications or supplements being taken
    • Urine Specimen: For Urine Complete - first morning urine sample preferred; collect 30-50 mL in sterile, non-sterile container depending on test requirements; process within 2 hours of collection for optimal accuracy
    • Special Instructions: Females should avoid testing during menstrual period or immediately after for urine collection; abstain from urination for 2 hours before collection if doing urine culture; inform laboratory if patient is on antibiotics as this may affect culture results
    • Other Tests in Package: CBC, Malarial Parasite Smear, ESR, Widal Test, and Dengue NS-1 Antigen do not require fasting and can be done at any time; timing should be coordinated with fasting requirements for efficiency
    • Important Note: In acute febrile illnesses, if fasting is not possible due to patient condition, tests can still be performed non-fasting; however, results should be interpreted with notation of non-fasting state; LFT values may be slightly elevated in non-fasting samples

How our test process works!

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