HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Does This Widal Test Report Indicate?

Posted on Mon, 19 Oct 2015

Question: Helo sr,

my widal test report is as follows
1/40 1/80 1/160 1/320
TO + + + -
TH + + + -
AH - - - -
BH - - - -
After 3 days again a widal test is done and report shows O and H +ve 1/320.

And typhidot test is non reactive.

PLEASE HELP ME TO READ THIS

Answered by Dr. Tushar Kanti Biswas (1 hour later)

Brief Answer:
Serologic tests for typhoid fever

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Your Widal test shows that there is two-fold rise in titre in both TO & TH from 1/160 to 1/320 indicating positive serological test for Typhoid fever.Repeated after 1 week instead of 3 days probably would have shown 4-fold rise in titre
The Widal test is generally considered positive if TO antigen titer is more than 1:160 in an active infection.
Your typhidot test [which detects IgM and IgG antibodies against the outer membrane protein (OMP) of the Salmonella typhi] is negative.

Both Widal test and typhidot test have lower positive predictive values than blood culture.Both tests lack sensitivity and specificity.

The definitive diagnosis of enteric fever requires positive culture of S. typhi from blood, bone marrow, other sterile sites XXXXXXX spots, stool, or intestinal secretions.

Hence in this case a clinician has to judge and come to a reasonable conclusion as the patent's condition dictates. I mean if there is no other cause for false positive Widal test like concomitant malaria,one can start standard antibiotic therapy for typhoid fever.

Regards

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

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Tushar Kanti Biswas (3 hours later)

So, we should go for some other test??

Answered by Dr. Tushar Kanti Biswas (4 minutes later)

Brief Answer:
Tests for Typhoid fever

Detailed Answer:
Hi,

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

Yes,Blood culture and Stool cultures ( if you are in the third week
of infection/fever),before staring any antibiotic therapy..

Regards

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

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Tushar Kanti Biswas (2 hours later)

Are you talking about CBC..??

Cbc report also available with me....
What parameter should be checked in that??

Answered by Dr. Tushar Kanti Biswas (52 minutes later)

Brief Answer:
Complete blood count (CBC) in suspected Typhoid fever

Detailed Answer:
CBC or complete blood count will not establish the diagnosis of typhoid fever.

Other than a positive culture, no specific laboratory test is diagnostic for Typhoid fever.
If CBC shows leukopenia and neutropenia (occurs in 15–25% of cases), it will only be supportive. However you can post your CBC for perusal.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Tushar Kanti Biswas (2 days later)

I have uploaded my complete cbc report. Kindly help me to read it along with my above reports.

Answered by Dr. Tushar Kanti Biswas (2 hours later)

Brief Answer:
Complete blood count (CBC) in suspected Typhoid fever

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Your CBC report shows mild anemia (HB 11.6G%).
Total WBC count is within range but it is low normal i.e.4,400/c mm.
Total WBC < 4000/c mm is termed as leucopenia.
Your neutrophil percentage is also low normal 49% (reference range 40-80 %) and absolute neutrophil count is 2160/c mm (reference range 2000-7000/ c mm).

That means your CBC report is more towards leucopenia and neutropenia ,though not copy book picture.

In clinical practice this CBC picture along with rising titre of TO & TH would be enough to make a diagnosis of typhoid fever and treat the patient accordingly.

Regards

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

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Tushar Kanti Biswas (12 minutes later)

Whether there is chance of typhoid or not?

Answered by Dr. Tushar Kanti Biswas (15 minutes later)

Brief Answer:
Typhoid fever

Detailed Answer:
Hi,

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

Yes,considering your widal test report and corroborative CBC report ,you have a chance of typhoid fever.

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. Vinay Bhardwaj