What Does The Following Widal Test Result Indicate?
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
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
i have attached available reports.
urine and blood culture says - no growth seen.
please advise
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