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Widal test positive, diagnosed typhoid. Which test can safely tell me whether i am free of typhoid or not??

I had my widal test which came out to be positive. My doctor has diagnosed typhoid fever seeing my widal reports. MP test also shows positive result. malaria has been diagnosed few days after widal test. after widal test my fever continued to rise. But after malaria has been detected and medicine given for that my fever only rises in late afternoon and that rises to around 101 . Should i go for blood culture test for proper diagnosis of typhoid? Which test can safely tell me whether i am free of typhoid or not??
Asked On : Wed, 3 Apr 2013
Answers:  2 Views:  120
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General & Family Physician 's  Response
Hi, thanks for asking in Healthcare Magic.

Frontal headache, high fever (step ladder like rise, higher in the evening), body ache, coated tongue with raw tips and edges, slight diarrhea with pea soup stools are all classic signs and symptoms of typhoid fever.
Widal test is positive by 10th day of fever. It is highly positive by 18th to 23rd day. But Widal titre has no correlation with the severity of the disease. A rising titre of O agglutinins indicates active disease. And, negative agglutination test does not exclude typhoid fever.
Blood culture is positive in 80% of people. Stool culture will be positive from 2nd week onwards.
it is not uncommon for malaria and typhoid to coexist.
The drug Chloroquine given in malaria is a febrifuge (reduces any type of fever) and that is why the fever has come down.
You have to confirm typhoid fever through blood culture. The specific antibiotics for typhoid like Ceftriaxone or Ciprofloxacin will cure you from typhoid fever.

I hope this is useful to you.
Answered: Wed, 3 Apr 2013
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General & Family Physician Dr. Naveed Rehman's  Response
hope you are doing good. Widal test is a serological test for typhoid. Ideally, the test has to be done for the first time around 5th to 7th day of illness and then repeated after 1-2 weeks to see the rising titres.
It is not a 100% confirmatory test for typhoid as the titres maybe high in certain areas depending on the endemicity of typhoid there. Also, we may see a positive test due to past immunization, previous infection, infection with other gram negative bacteria.

The gold standard for diagnosis is isolation of salmonella bacteria by culture from blood/urine or stool. In absence of fever or other symptoms, widal alone would not suffice to diagnose typhoid in your case.

I Hope you are satisfied with the answer.
Take care.
Answered: Wed, 3 Apr 2013
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