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What Does The Following Widal Test Result Indicate?

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Posted on Mon, 27 Feb 2017
Question: Hi! I have been sick for the past 3 and a half months. It started with fever and cold and cough, eveey 2 weeks have been falling sick. I did a blood count test to rule out any infection and the blood count was normal. But still comtinued to fall sick. Would get fever regularly within 100 degrees.
I have got an extensive test done 3 days back

My widal test result is
S.Typhii O - 1.80
S.Typhii H -1.80
Paratyphi AH BH is negative

Anti streptolysin O titre is 247

The doctor I consulted her suggested slight trace of tyhopid and rheumatic fever


Past 2 days I'm having weird stomach pain.

Need suggestion
doctor
Answered by Dr. Tushar Kanti Biswas (8 hours later)
Brief Answer:
Fever (investigation)

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

Widal titre is often false positive and a single titre is inconclusive. A four-fold rise in titre after a week interval is more diagnostic of typhoid fever. If you are already on some empirical antibiotic, that too can blunt antibody response in typhoid fever.

Raised ASO (Anti streptolysin O ) titre more than 250 XXXXXXX units in adult is supportive of acute Rheumatic fever . Yours is 247 units.

So in your case one has to go by clinical parameters (history and physical examination).
I feel an X-ray chest PA view and Ultrasonography abdomen will give some clue to underlying disease.

Please upload all other investigations like complete blood count (CBC), ESR(fasting), peripheral smear for Malaria parasite, urine routine examination report etc (might have already been done).

Regards

Dr. T.K. Biswas M.D. XXXXXXX


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Tushar Kanti Biswas (18 hours later)
Hi Doctor ,

i have attached available reports.

urine and blood culture says - no growth seen.

please advise
doctor
Answered by Dr. Tushar Kanti Biswas (5 hours later)
Brief Answer:
Fever of unknown origin ( FUO )

Detailed Answer:
I have gone through your reports.All investigations are within normal range including serological tests to exclude any connective tissue disease. Typhoid is ruled out as it will not prolong for 3 months.You are having fever of unknown origin (FUO). 2-D Echocardiogram may be justified to exclude any infective endocarditis (depending upon any presence of cardiac murmur clinically).

Have you lost any body weight ? What about your appetite ?

In XXXXXXX majority of FUO boils down to Tuberculosis. X-ray chest can be repeated after 3 weeks ((time taken for radiological opacity to appear) or HRCT chest can be done to exclude any miliary tuberculosis.Mottling of <0.5 mm is not detectable in X-ray.

Regards

Dr. T.K. Biswas M.D. XXXXXXX
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1920 Questions

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What Does The Following Widal Test Result Indicate?

Brief Answer: Fever (investigation) Detailed Answer: Hi, Thank you for your query. I can understand your concerns. Widal titre is often false positive and a single titre is inconclusive. A four-fold rise in titre after a week interval is more diagnostic of typhoid fever. If you are already on some empirical antibiotic, that too can blunt antibody response in typhoid fever. Raised ASO (Anti streptolysin O ) titre more than 250 XXXXXXX units in adult is supportive of acute Rheumatic fever . Yours is 247 units. So in your case one has to go by clinical parameters (history and physical examination). I feel an X-ray chest PA view and Ultrasonography abdomen will give some clue to underlying disease. Please upload all other investigations like complete blood count (CBC), ESR(fasting), peripheral smear for Malaria parasite, urine routine examination report etc (might have already been done). Regards Dr. T.K. Biswas M.D. XXXXXXX