Medicine Reaction Jakavi (polycythemia Patient)

Question

From past 4-5 days, my abu is having severe fever till 103C and not coming below 100. until we go hospital for treatment where they use Falagan and Solucortif 100 mg to lower down the fever and only having Panadol 2 tabs after 8 hours.
Anyhow, Platelets were drop to 50k and alter after 2 days they start increasing and last test was showing around 130k. Sam WBC and HB were below range too. 
After Showing to Medical specialist he advise to stop the medicine Jakavi and Ascard. we did the same since 19th May. so far its 48 hours and reaction is still there, until we gave Moxi get 400 and Nise after Doc Prescribed yesterday night. 
Later My dad has started sweating even in AC room. So its been 14 hours, he has no fever but he is feeling no potential (too lazy, like no will power of doing something) in his body to do any work or even sit straight. 
Kindly advise two things:
1. As i\'ve shared a sudden change come after taking antibiotic , so is it going in right direction , means soon he

Dr. Syed Asif Raza · Answer

His senses of taste & smell are perfect?
Any test done?
if not please go for
Advice: MP ICT & Blood C/S Urine DR if after 5 days of antibiotic he again started to feel like that.If he is not hypertensive then give Inj. N/S 100ml+Inj. Neurobion IV
h

Dr. Kholod Shafi · Answer

Polycythemia itself can be a reason that your father is feeling excessive sweating and lethargy. Secondly being on Jakavi means this is Polycythemoa vera which makes him have weak immunity so easy to contract infections also Jakavi does the same makes one vulnerable to contract infections. BLOOD culture should have been done along with urine culture and chest checked for any other signs.Does he have any other symptoms to chest? Antibiotic will take 24-48hours to come in full affect depending on the infection. Keep him hydrated. If he is hypertensive or diabetic them mix 1 sachet of ORS in 1.5 liter or if not then regular 1 sachet in 1 liter. He is profusely sweating which will make him more lethargic. Monitor his temperature of above 103 or above please cold compress and keep him well ventilated. Now blood culture can be done 14 days after use of antibiotic to get proper results if condition remains same.
Sometime tiredness and lethargy is also a result of withdrawal affect of Jakavi. The shift in blood profile makes one contract infections. Stay put with antibiotic for 48 hours to show affect.

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Dr. Syed Asif Raza - General Physician

MBBS, Dip(Diabetes), Dip(Gastro), Member International Society for Infectious Diseases, IPC for CoronaVirus (WHO Cerification), Mechanical Ventilation-COVID19 (Harvard Medical School Certification) | Karachi

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Dr. Kholod Shafi - General Physician

MBBS, Certified Fitness Trainer, Certified Nutritionist | Karachi

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