Evaluation of variable diagnostic modalities of typhoid fever

Abstract EN

This study included 160 patients with highly suggestive clinical picture of enteric fever.

A control group of 30 patients with diseases other than enteric fever with positive widal test at a titer > 1/160 for (O) and (H) agglutinins was included Blood culture (BC) was positive in 82 out of 160patients representing 51.2%.

The highest isolation rate in our study was found in the 1st week of fever (83.3%).

The overall positivity rate of stool culture (SC) in our patients was 18.6% (28 out of 150 cases), the positivity of stool culture (SC) increased slightly with the longer duration of fever.

Seven patients with negative BC were positive by SC.

Among 14patients who were subjected to bone marrow culture (B.M.C), 10patients (71.42%) were positive.

B.M.C was positive in 4 patients in whom BC was negative.

The overall positivity rate by the three culture methods was 58.12% (93 out of 160patients).

All the isolated strains by these culture methods were S.

typhi.

The specificity of Widal test and -modified Widal test versus culture is very poor (0% ' 5.79% respectively).

The modified Widal test is a good test with high sensitivity and specificity (95.64% and 93.33% respectively) in Widal positive cases in order to differentiate these with culture positive from the control group.

We concluded that there is an over estimation of clinical diagnosis of typhoid fever in our community.

Culture methods are still the gold standard in diagnosis of typhoid fever.

The yield] of combined culture methods is better than blood culture alone.

The modified Widal test «* be used only to exclude cases with positive Widal test due to diseases other than typhoid