Different Diagnostic Procedure of Typhoid Fever A
Different Diagnostic Procedure of Typhoid Fever A
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REVIEW ARTICLE
Abstract
Typhoid fever is diagnosed by using a combination of the clinical presentation, the isolation of
Salmonella typhi from body fluids and by Widal test. In the first week of illness, the diagnosis may be
more difficult because in this invasive stage with bacteraemia; the symptoms are those of generalized
infections without localizing feature. Cultures of stool, urine, rose spots, bone marrow, gastric and
intestinal secretions can all be useful for diagnosis. The efficacy of culture varies with the specimen
being tested. In addition, the prehospital antibiotic therapy frequently used in developing countries
complicates the isolation of infectious agents from clinical specimens especially from blood. Bone
marrow appears to be the most suitable specimen because bone marrow culture has a higher
sensitivity than blood culture. The methods of bacterial isolation are inherently slow and take more
than 48 hours. That is why, serologic analysis becomes more important. The Widal test has got
limitations such as the difficulty in interpretation, the need to demonstrate a fourfold rise after a week
and necessity of knowing the endemicity of the area and is useful only in selected patients. The
available methods of diagnosis of typhoid fever are either time consuming or are not absolutely
reliable. An accurate diagnosis of typhoid at an early stage is important not only for an etiological
diagnosis of the patient but also to identify individuals who may serve as a source of infection. The
outer membrane protein on the surface of Gram negative bacteria has been considered as important
antigens to induce host immune response. Enzyme-linked immunosorbent assays (ELISA) have been
considered an alternative approach for the diagnosis of typhoid fever. Therefore, this present review
has been designed to describe the different diagnostic procedure of typhoid fever.
[Cite this article as: Sattar AFMA, Yusuf MA, Islam MB, Jahan WA. Different Diagnostic
Procedure of Typhoid Fever: A Review Update. J Curr Adv Med Res 2014;1(1):35-41]
Correspondence: Dr. AFM Arshedi Sattar, Assistant Professor, Department of Microbiology,
National Institute of Neurosciences & Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka-1207,
Bangladesh; Email: [email protected]; Cell no.: +8801611109942
Conflict of Interest: None
Contributions to authors: AFMAS & MAY have contributed in manuscript writing. MBI & WAJ
have revised the manuscript.