Laboratory diagnosis of typhoid fever in Accra
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Date
2000-06
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Publisher
Ghana Medical Journal
Abstract
The aim of this investigation was to evaluate the
most appropriate method for the diagnosis of Salmonella
typhi septicaemia. This involved the culture
of blood samples, Widal test and antibiotic
sensitivity test. Of 50 patients suspected of having
typhoid fever, blood cultures of 38 (76%) yielded
no bacterial growth, while 12 (24%) produced bacterial
growth. Organisms encountered included
Salmonella typhi, Kblebsiella species and Staphylococcus
aureus. Antibody to the 0 and H antigens
was detected in 20 serum samples using the Widal
test. Out of this number, 7 patients diagnosed to
have S typhi infection had antibodies titres of
1/80. Convalescent sera from all diagnosed cases
of S typhi showed at least a two-fold rise in titre. In
addition those infected with Klebsiella sp. and
Staphylococci also had low antibodies titres to 0
and H antigens. It was also discovered that 9 patienls
who had no bacterial growth also had titres of
<1/80 to 0 and H antigens. The S typhi isolates
were all sensitive to Cefotaxime and Ofloxacin,
both third line drugs so it will be prudent to keep
them as such. Although one strain was resistant to
Chloramphenicol, it still remains the antibiotic of
choice. The widal test, like all inununological assays,
cannot be positive by mere detection of antibody
but based on a cut-off point. It must, therefore,
be carefully interpreted and used together with
blood cultures and clinical findings to safely diagnose
S. typhi infections.
Description
Journal Article
Keywords
Widal test, typhoid fever, Klebsiella sp., blood cultures, Accra, S typhi