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

Hoffman, Stephen L.; Edman, David C.; Punjabi, Narain H.; Lesmana, Murad; Cholid, Abdul; Sundah, Sientje; Harahap, Jamas

doi:10.4269/ajtmh.1986.35.836

Cited by 50 publications

(30 citation statements)

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“…Other limiting factors, beside the bacteriostatic effect of antibiotics (already administered before the culture sample is taken), may be the nature of culture medium employed, the time of blood collection, the host's immune response system, and the intracellular characteristics of Salmonella typhi. 6,21 Although detection of Salmonella typhi by using labeled probes is 99% specific, 14 its sensitivity is poor because it cannot detect less than 500 bacteria/mL. 13 The recent introduction of PCR techniques 15,16 offers highly specific, sensitive and reasonably quick diagnostic modality.…”

Section: Discussionmentioning

confidence: 99%

Early Detection of Typhoid by Polymerase Chain Reaction

1999

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Background: Typhoid is a common problem in developing countries. Cultivation of bacteria and serology (especially Widal test) give unacceptable levels of false-negative and false-positive results, respectively. Patients and Methods: In this study, a recently introduced polymerase chain reaction-based technique (which has 100% specificity for Salmonella typhi) was compared with blood culture and Widal test during the first week of illness of 82 suspected cases of typhoid. Results: The respective figures of positivity for PCR, blood culture and Widal test were 71.95%, 34.1%, and 36.5%. A control group of 20 healthy persons gave figures of 0%, 0%, and 33.3%, respectively. Conclusion: We conclude that this PCR-based technique is not only absolutely specific, but also very sensitive and, therefore, much superior to blood culture and Widal test for the early diagnosis of typhoid.

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Section: Discussionmentioning

confidence: 99%

Early Detection of Typhoid by Polymerase Chain Reaction

1999

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“…Studies in Pakistan and Bangladesh show the mean age of patients affected with typhoid fever is 7 years. 8,9 Typhoid is found to be a seasonal disease; in the monsoon itself there is occurrence of 45% of the total annual reported cases. In South Asia the disease occurrence is highest during July to October because of heavy rainfall during that period.…”

Section: Epidemiologymentioning

confidence: 99%

“…8 There are several factors responsible. Low income inhabitants of this area frequently use surface water for drinking.…”

Section: Treatmentmentioning

confidence: 99%

“…In South Asia the disease occurrence is highest during July to October because of heavy rainfall during that period. 8 Proper standardization of the methods of epidemiological studies on typhoid is therefore deemed necessary. 10 Buckle et al did an elaborate review using standardized survey methods with 24 studies that examined typhoid fever incidences and employed blood culture as the criteria for diagnosis.…”

Section: Epidemiologymentioning

confidence: 99%

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Typhoid fever: a review

Paul¹,

Bandyopadhyay²

2017

Int J Adv Med

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Typhoid fever is still a deadly disease in developing countries, particularly in India. Although, the paediatric population is mostly affected by this disease, yet the disease is an important cause of morbidity and mortality in adult populations also. In India, most of the cases of typhoid fever are diagnosed clinically, or at the most by the Widal test which is not fool proof. The disease typhoid fever is an orally transmitted communicable infectious disease caused by the bacteria Salmonella typhi. It is usually caused by consuming impure water and contaminated food. Salmonella typhi is serologically positive for lipopolysaccharide antigens O9 and O12, protein ﬂagellar antigen Hd, and polysaccharide capsular antigen Vi. S. typhi Vi-positive strains are more infectious and virulent than Vi-negative strains. Following the incubation period of 7 to 14 days, there is onset of fever and malaise. The fever is then accompanied by chills, headache, malaise, anorexia, nausea, vague abdominal discomfort, dry cough and myalgia. These are followed by coated tongue, tender abdomen, hepatomegaly, and splenomegaly. Azithromycin (10mg/kg) given once daily for seven days has proven eﬀective in the treatment of typhoid fever in some adults and children. A dose of 1g per day for ﬁve days was also found to be more effective in most adults. Of the third generation cephalosporins, oral Ceﬁxime (15-20mg per kg per day, for adults, 100-200mg twice daily) has been widely used. Intravenous third generation cephalosporins (ceftriaxone, cefotaxime) are eﬀective. Aztreonam and imipenem are potential third line drugs.

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“…Even though an array of specimens including whole blood, bone marrow, stool, duodenal fluid, urine and skin (Rose spots) (Gilman et al, 1975;Vallenas et al, 1985;Hoffman et al, 1986;Rubin et al, 1990) have historically been shown to harbor cultivable bacteria, blood is the most common specimen submitted for culture of S. Typhi (Parry et al, 2002;Wain and Hosoglu 2008). Between 45 and 70% of patients with typhoid fever may be diagnosed by blood culture (World Health Organization, 2003;Wain et al, 2001.…”

Section: Bacterial Culturementioning

confidence: 99%