Diagnosis of Typhoid : a Clinician's Dilema

Résumé du livre

Clinical diagnosis of typhoid fever is unreliable. Isolation of S.typhi remains the gold standard for aetiological diagnosis of this condition. But facilities for cultures are often not available or limited in many developing countries. In such areas, diagnosis of typhoid is often made by a combination of a clinical picture consistent with typhoid plus a "significant" Widal titre. However, many limitations lead to difficulties in the interpretation of the Widal test results. We therefore evaluated the diagnostic value of the EIA (Enzyme Immunoassay) versus the Widal test in 109 children admitted to a Malaysian hospital. The study revealed that in the confirmed typhoid group (TYP-CP, n+42), the EIA test was positive (either IgM and/or IgG antibody to S. typhi detected at 1/100 dilution of serum) in 42/42 children whilst the Widal test was positive (significant titres when either "o" and/of "H">1/40) in 41/42 children.