A Comparative Study of Blood Culture and Antibody Response with the Duration of Illness in Diagnosis of Typhoid Fever

Diagnosis of typhoid fever is difficult because it is non-specific symptoms and signs with those of other acute febrile illness. Blood cultures, and antibody levels of O& H, were evaluated, in the diagnosis of typhoid fever in Egyptian hospitals. Patients were divided into three groups: (I) 254 with blood culture-confirmed typhoid, (II) 3426 febrile patients with negative blood cultures, and (III) 176 with other bacteremic pathogens. In-group (I), 77% had (O&H) antibody titers > 1:160, compared to 12% of group (II), and 8% of group (III). Among group (1), 73% of patients were culture positive for typhoid, in the first week after symptom onset as compared to 89% in the second week and later. The Widal titer of > 1/160 had sensitivity of 77 %, and specificity of 89%. In the first week the sensitivity of confirmed blood cultures, and antibody titer of > 1/160, are almost the same, while in the second week and after, the positive Widal serology is much higher than the confirmed blood cultures. The O and H antibody titers of > 1/160 of single Widal test is useful in the diagnosis of typhoid fever