Typhoid fever laboratory findings: Difference between revisions
Jump to navigation
Jump to search
Aysha Aslam (talk | contribs) |
Aysha Aslam (talk | contribs) |
||
| Line 29: | Line 29: | ||
===Molecular diagnosis=== | ===Molecular diagnosis=== | ||
====Serology==== | ====Serology==== | ||
*'''Widal test''' | *'''Widal test''' | ||
::*Detection of antibodies against O and H antigen of ''[[Salmonella enterica]]'' serotype.<ref name="pmid9055495">{{cite journal| author=Shukla S, Patel B, Chitnis DS| title=100 years of Widal test & its reappraisal in an endemic area. | journal=Indian J Med Res | year= 1997 | volume= 105 | issue= | pages= 53-7 | pmid=9055495 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9055495 }} </ref> | |||
*''' | ::*Sensitivity, specificity and predictive values varies in various parts of the world. | ||
::*A fourfold rise in antibody titre may be considered positive | |||
*'''Elisa for chronic carriers''' | *'''Elisa for chronic carriers''' | ||
::*Detects agglutinating antibodies against Vi antigen. | |||
::*May help detects chronic carrier state in endemic areas.<ref name="pmid6192305">{{cite journal| author=Lanata CF, Levine MM, Ristori C, Black RE, Jimenez L, Salcedo M et al.| title=Vi serology in detection of chronic Salmonella typhi carriers in an endemic area. | journal=Lancet | year= 1983 | volume= 2 | issue= 8347 | pages= 441-3 | pmid=6192305 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6192305 }} </ref> | |||
*'''Newer antibopdy tests''' | |||
::*Typhidot test<ref> Bhutta, Zulfiqar Ahmed, and Naseem Mansurali. "Rapid serologic diagnosis of pediatric typhoid fever in an endemic area: a prospective comparative evaluation of two dot-enzyme immunoassays and the Widal test." The American journal of tropical medicine and hygiene 61.4 (1999): 654-657.</ref> | |||
::*May be used in areas lacking facilities for culture detection of S.typhi.<ref name="pmid11230418">{{cite journal| author=House D, Wain J, Ho VA, Diep TS, Chinh NT, Bay PV et al.| title=Serology of typhoid fever in an area of endemicity and its relevance to diagnosis. | journal=J Clin Microbiol | year= 2001 | volume= 39 | issue= 3 | pages= 1002-7 | pmid=11230418 | doi=10.1128/JCM.39.3.1002-1007.2001 | pmc=87864 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11230418 }} </ref> | |||
====PCR==== | ====PCR==== | ||
::*May help detect S.typhi in culture negative patients with strong clinical suspicion.<ref name="pmid8314983">{{cite journal| author=Song JH, Cho H, Park MY, Na DS, Moon HB, Pai CH| title=Detection of Salmonella typhi in the blood of patients with typhoid fever by polymerase chain reaction. | journal=J Clin Microbiol | year= 1993 | volume= 31 | issue= 6 | pages= 1439-43 | pmid=8314983 | doi= | pmc=265558 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8314983 }} </ref> | |||
===other tests=== | ===other tests=== | ||
Revision as of 15:29, 30 August 2016
|
Typhoid fever Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Typhoid fever laboratory findings On the Web |
|
American Roentgen Ray Society Images of Typhoid fever laboratory findings |
|
Risk calculators and risk factors for Typhoid fever laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
Laboratory findings
Laboratory findings consistent with the diagnosis of typhoid fever include:[1][2]
Microscopic diagnosis
Culture
Cultures from the following sites may help establishing the diagnosis.[1][3][4][5][6]
Blood culture
Stool culture
- Positive in 30 percent of the patients with acute typhoid fever.
- May be more effective in children.[4]
Bone marrow culture
Culture from the other sites
Molecular diagnosis
Serology
- Widal test
- Detection of antibodies against O and H antigen of Salmonella enterica serotype.[9]
- Sensitivity, specificity and predictive values varies in various parts of the world.
- A fourfold rise in antibody titre may be considered positive
- Elisa for chronic carriers
- Detects agglutinating antibodies against Vi antigen.
- May help detects chronic carrier state in endemic areas.[10]
- Newer antibopdy tests
PCR
- May help detect S.typhi in culture negative patients with strong clinical suspicion.[13]
other tests
Diagnosis is made by blood, bone marrow or stool cultures and with the Widal test (demonstration of salmonella antibodies against antigens O-somatic and H-flagellar). In epidemics and less wealthy countries, after excluding malaria, dysentery or pneumonia, a therapeutic trial time with chloramphenicol is generally undertaken while awaiting the results of Widal test and blood cultures.[14]
References
- ↑ 1.0 1.1 Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ (2002). "Typhoid fever". N Engl J Med. 347 (22): 1770–82. doi:10.1056/NEJMra020201. PMID 12456854.
- ↑ Wain J, Diep TS, Ho VA, Walsh AM, Nguyen TT, Parry CM; et al. (1998). "Quantitation of bacteria in blood of typhoid fever patients and relationship between counts and clinical features, transmissibility, and antibiotic resistance". J Clin Microbiol. 36 (6): 1683–7. PMC 104900. PMID 9620400.
- ↑ 3.0 3.1 Gilman RH, Terminel M, Levine MM, Hernandez-Mendoza P, Hornick RB (1975). "Relative efficacy of blood, urine, rectal swab, bone-marrow, and rose-spot cultures for recovery of Salmonella typhi in typhoid fever". Lancet. 1 (7918): 1211–3. PMID 48834.
- ↑ 4.0 4.1 4.2 4.3 Vallenas C, Hernandez H, Kay B, Black R, Gotuzzo E (1985). "Efficacy of bone marrow, blood, stool and duodenal contents cultures for bacteriologic confirmation of typhoid fever in children". Pediatr Infect Dis. 4 (5): 496–8. PMID 3900945.
- ↑ 5.0 5.1 Hoffman SL, Edman DC, Punjabi NH, Lesmana M, Cholid A, Sundah S; et al. (1986). "Bone marrow aspirate culture superior to streptokinase clot culture and 8 ml 1:10 blood-to-broth ratio blood culture for diagnosis of typhoid fever". Am J Trop Med Hyg. 35 (4): 836–9. PMID 3089041.
- ↑ Rubin FA, McWhirter PD, Burr D, Punjabi NH, Lane E, Kumala S; et al. (1990). "Rapid diagnosis of typhoid fever through identification of Salmonella typhi within 18 hours of specimen acquisition by culture of the mononuclear cell-platelet fraction of blood". J Clin Microbiol. 28 (4): 825–7. PMC 267809. PMID 2332479.
- ↑ 7.0 7.1 Gasem MH, Dolmans WM, Isbandrio BB, Wahyono H, Keuter M, Djokomoeljanto R (1995). "Culture of Salmonella typhi and Salmonella paratyphi from blood and bone marrow in suspected typhoid fever". Trop Geogr Med. 47 (4): 164–7. PMID 8560588.
- ↑ 8.0 8.1 Hoffman SL, Punjabi NH, Rockhill RC, Sutomo A, Rivai AR, Pulungsih SP (1984). "Duodenal string-capsule culture compared with bone-marrow, blood, and rectal-swab cultures for diagnosing typhoid and paratyphoid fever". J Infect Dis. 149 (2): 157–61. PMID 6421940 PMID: 6421940 Check
|pmid=value (help). - ↑ Shukla S, Patel B, Chitnis DS (1997). "100 years of Widal test & its reappraisal in an endemic area". Indian J Med Res. 105: 53–7. PMID 9055495.
- ↑ Lanata CF, Levine MM, Ristori C, Black RE, Jimenez L, Salcedo M; et al. (1983). "Vi serology in detection of chronic Salmonella typhi carriers in an endemic area". Lancet. 2 (8347): 441–3. PMID 6192305.
- ↑ Bhutta, Zulfiqar Ahmed, and Naseem Mansurali. "Rapid serologic diagnosis of pediatric typhoid fever in an endemic area: a prospective comparative evaluation of two dot-enzyme immunoassays and the Widal test." The American journal of tropical medicine and hygiene 61.4 (1999): 654-657.
- ↑ House D, Wain J, Ho VA, Diep TS, Chinh NT, Bay PV; et al. (2001). "Serology of typhoid fever in an area of endemicity and its relevance to diagnosis". J Clin Microbiol. 39 (3): 1002–7. doi:10.1128/JCM.39.3.1002-1007.2001. PMC 87864. PMID 11230418.
- ↑ Song JH, Cho H, Park MY, Na DS, Moon HB, Pai CH (1993). "Detection of Salmonella typhi in the blood of patients with typhoid fever by polymerase chain reaction". J Clin Microbiol. 31 (6): 1439–43. PMC 265558. PMID 8314983.
- ↑ Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0838585299.