Typhoid fever laboratory findings: Difference between revisions
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===Culture=== | ===Culture=== | ||
Cultures from the following sites may help establishing diagnosis<ref name="pmid12456854">{{cite journal| author=Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ| title=Typhoid fever. | journal=N Engl J Med | year= 2002 | volume= 347 | issue= 22 | pages= 1770-82 | pmid=12456854 | doi=10.1056/NEJMra020201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12456854 }} </ref><ref name="pmid48834">{{cite journal| author=Gilman RH, Terminel M, Levine MM, Hernandez-Mendoza P, Hornick RB| title=Relative efficacy of blood, urine, rectal swab, bone-marrow, and rose-spot cultures for recovery of Salmonella typhi in typhoid fever. | journal=Lancet | year= 1975 | volume= 1 | issue= 7918 | pages= 1211-3 | pmid=48834 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=48834 }} </ref><ref name="pmid3900945">{{cite journal| author=Vallenas C, Hernandez H, Kay B, Black R, Gotuzzo E| title=Efficacy of bone marrow, blood, stool and duodenal contents cultures for bacteriologic confirmation of typhoid fever in children. | journal=Pediatr Infect Dis | year= 1985 | volume= 4 | issue= 5 | pages= 496-8 | pmid=3900945 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3900945 }} </ref><ref name="pmid3089041">{{cite journal| author=Hoffman SL, Edman DC, Punjabi NH, Lesmana M, Cholid A, Sundah S et al.| title=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. | journal=Am J Trop Med Hyg | year= 1986 | volume= 35 | issue= 4 | pages= 836-9 | pmid=3089041 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3089041 }} </ref><ref name="pmid2332479">{{cite journal| author=Rubin FA, McWhirter PD, Burr D, Punjabi NH, Lane E, Kumala S et al.| title=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. | journal=J Clin Microbiol | year= 1990 | volume= 28 | issue= 4 | pages= 825-7 | pmid=2332479 | doi= | pmc=267809 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2332479 }} </ref> | Cultures from the following sites may help establishing diagnosis<ref name="pmid12456854">{{cite journal| author=Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ| title=Typhoid fever. | journal=N Engl J Med | year= 2002 | volume= 347 | issue= 22 | pages= 1770-82 | pmid=12456854 | doi=10.1056/NEJMra020201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12456854 }} </ref><ref name="pmid48834">{{cite journal| author=Gilman RH, Terminel M, Levine MM, Hernandez-Mendoza P, Hornick RB| title=Relative efficacy of blood, urine, rectal swab, bone-marrow, and rose-spot cultures for recovery of Salmonella typhi in typhoid fever. | journal=Lancet | year= 1975 | volume= 1 | issue= 7918 | pages= 1211-3 | pmid=48834 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=48834 }} </ref><ref name="pmid3900945">{{cite journal| author=Vallenas C, Hernandez H, Kay B, Black R, Gotuzzo E| title=Efficacy of bone marrow, blood, stool and duodenal contents cultures for bacteriologic confirmation of typhoid fever in children. | journal=Pediatr Infect Dis | year= 1985 | volume= 4 | issue= 5 | pages= 496-8 | pmid=3900945 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3900945 }} </ref><ref name="pmid3089041">{{cite journal| author=Hoffman SL, Edman DC, Punjabi NH, Lesmana M, Cholid A, Sundah S et al.| title=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. | journal=Am J Trop Med Hyg | year= 1986 | volume= 35 | issue= 4 | pages= 836-9 | pmid=3089041 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3089041 }} </ref><ref name="pmid2332479">{{cite journal| author=Rubin FA, McWhirter PD, Burr D, Punjabi NH, Lane E, Kumala S et al.| title=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. | journal=J Clin Microbiol | year= 1990 | volume= 28 | issue= 4 | pages= 825-7 | pmid=2332479 | doi= | pmc=267809 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2332479 }} </ref> | ||
'''Blood culture''' | '''Blood culture''' | ||
:*Standard means of establishing diagnosis.<ref name="pmid3900945">{{cite journal| author=Vallenas C, Hernandez H, Kay B, Black R, Gotuzzo E| title=Efficacy of bone marrow, blood, stool and duodenal contents cultures for bacteriologic confirmation of typhoid fever in children. | journal=Pediatr Infect Dis | year= 1985 | volume= 4 | issue= 5 | pages= 496-8 | pmid=3900945 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3900945 }} </ref> | :*Standard means of establishing diagnosis.<ref name="pmid3900945">{{cite journal| author=Vallenas C, Hernandez H, Kay B, Black R, Gotuzzo E| title=Efficacy of bone marrow, blood, stool and duodenal contents cultures for bacteriologic confirmation of typhoid fever in children. | journal=Pediatr Infect Dis | year= 1985 | volume= 4 | issue= 5 | pages= 496-8 | pmid=3900945 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3900945 }} </ref> | ||
| Line 25: | Line 26: | ||
:*Culture of skin lesions | :*Culture of skin lesions | ||
:*Culture of duodenal contents<ref name="pmid3900945">{{cite journal| author=Vallenas C, Hernandez H, Kay B, Black R, Gotuzzo E| title=Efficacy of bone marrow, blood, stool and duodenal contents cultures for bacteriologic confirmation of typhoid fever in children. | journal=Pediatr Infect Dis | year= 1985 | volume= 4 | issue= 5 | pages= 496-8 | pmid=3900945 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3900945 }} </ref><ref name="pmidPMID: 6421940">{{cite journal| author=Hoffman SL, Punjabi NH, Rockhill RC, Sutomo A, Rivai AR, Pulungsih SP| title=Duodenal string-capsule culture compared with bone-marrow, blood, and rectal-swab cultures for diagnosing typhoid and paratyphoid fever. | journal=J Infect Dis | year= 1984 | volume= 149 | issue= 2 | pages= 157-61 | pmid=PMID: 6421940 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6421940 }} </ref> | :*Culture of duodenal contents<ref name="pmid3900945">{{cite journal| author=Vallenas C, Hernandez H, Kay B, Black R, Gotuzzo E| title=Efficacy of bone marrow, blood, stool and duodenal contents cultures for bacteriologic confirmation of typhoid fever in children. | journal=Pediatr Infect Dis | year= 1985 | volume= 4 | issue= 5 | pages= 496-8 | pmid=3900945 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3900945 }} </ref><ref name="pmidPMID: 6421940">{{cite journal| author=Hoffman SL, Punjabi NH, Rockhill RC, Sutomo A, Rivai AR, Pulungsih SP| title=Duodenal string-capsule culture compared with bone-marrow, blood, and rectal-swab cultures for diagnosing typhoid and paratyphoid fever. | journal=J Infect Dis | year= 1984 | volume= 149 | issue= 2 | pages= 157-61 | pmid=PMID: 6421940 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6421940 }} </ref> | ||
===Serology=== | ===Serology=== | ||
Revision as of 14:34, 30 August 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory findings
Laboratory findings consistent with the diagnosis of typhoid fever include:[1][2]
Culture
Cultures from the following sites may help establishing diagnosis[1][3][4][5][6]
Blood culture
Stool culture
- Positive in 30 percent of patients with acute typhoid fever
- May be more effective in children[4]
Bone marrow culture
Culture from other sites
Serology
Widal test Newer rapid antigen test Elisa for chronic carriers
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.[9]
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.
- ↑ 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). - ↑ Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0838585299.