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Does The Following Widal Slide Test Result Suggest Typhoid Fever?
Question: Hello Doctor,
My son (age 11 yrs) has been having fever over the last 3 days but has come down a bit. Widal Slide test today showed Salmonella Typhi - O and H both as1:80 dilution. His WBC is around 3050 and ESR was 15mm in the 1st hour.
Is this a clear case of typhoid? Also, anything to specifically interpret on WBC and ESR? Please help.
My son (age 11 yrs) has been having fever over the last 3 days but has come down a bit. Widal Slide test today showed Salmonella Typhi - O and H both as1:80 dilution. His WBC is around 3050 and ESR was 15mm in the 1st hour.
Is this a clear case of typhoid? Also, anything to specifically interpret on WBC and ESR? Please help.
Brief Answer:
Widal test ?typhoid fever
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Single titre of Widal test for "febrile agglutinins," is not sufficiently sensitive or specific for the diagnosis of typhoid fever,because of false positivity. .It is the rise in titre of Salmonella Typhi - O and H which is more diagnostic.You have to repeat Widal test after 1 week.
The definitive diagnosis of typhoid fever requires the isolation of S. typhi from blood (sensitivity of blood culture is 40–80%). Your doctor might have send blood for culture. Wait for the culture report.
In 15–25% of cases, leukopenia and neutropenia are detectable. Your son's WBC count is 3060/c mm i.e below 4000/c.mm indicating leucopenia.
ESR is non-specific.
Other than a positive culture, no specific laboratory test is diagnostic for typhoid fever.
However many a times blood culture may report negative for various reasons.In such case depending upon the clinical course treating physician has to take the decision.Since the clinical presentation of typhoid fever is relatively nonspecific, a host of other infections including malaria, hepatitis, dengue fever, rickettsial infections, leptospirosis, to name a few have to be excluded.
What antibiotic ,he is on now ? Usually if there is high suspicion of typhoid fever ,antibiotic covering salmonella typhi (causative organism of typhoid fever ) is started pending culture report.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Widal test ?typhoid fever
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Single titre of Widal test for "febrile agglutinins," is not sufficiently sensitive or specific for the diagnosis of typhoid fever,because of false positivity. .It is the rise in titre of Salmonella Typhi - O and H which is more diagnostic.You have to repeat Widal test after 1 week.
The definitive diagnosis of typhoid fever requires the isolation of S. typhi from blood (sensitivity of blood culture is 40–80%). Your doctor might have send blood for culture. Wait for the culture report.
In 15–25% of cases, leukopenia and neutropenia are detectable. Your son's WBC count is 3060/c mm i.e below 4000/c.mm indicating leucopenia.
ESR is non-specific.
Other than a positive culture, no specific laboratory test is diagnostic for typhoid fever.
However many a times blood culture may report negative for various reasons.In such case depending upon the clinical course treating physician has to take the decision.Since the clinical presentation of typhoid fever is relatively nonspecific, a host of other infections including malaria, hepatitis, dengue fever, rickettsial infections, leptospirosis, to name a few have to be excluded.
What antibiotic ,he is on now ? Usually if there is high suspicion of typhoid fever ,antibiotic covering salmonella typhi (causative organism of typhoid fever ) is started pending culture report.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
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Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Answered by
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