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What does my grandmother’s widal test report suggest?

Q: What does the following widal test report of a 60 years old grandmother suggest?

  • AO - Negative
  • AH - Negative
  • BO - Positive up to 1 in 80 dilution
  • BH - Positive up to 1 in 80 dilution
  • TO - Negative
  • TH - Positive up to 1 in 80 dilution

What is the clinical implication of this report? Is she suffering from typhoid?

A:The result indicate possible exposure to the antigens of Salmonella enterica serovar Typhi and Salmonella enterica serovar Paratyphi B. This may occur either due to exposure to these antigens through infections or due to vaccination. Widal test, although extensively used in the Indian context, is not ideal for the diagnosis of Typhoid or Paratyphoid fevers (also known as Enteric fevers). The test can give rise to non-specific reactivity due to cross reactivity to several other related or unrelated antigens (malaria, dengue, etc). The definitive diagnosis of Enteric fever is dependent on the isolation of the bacteria from clinical samples (blood culture). In order to interpret the results of the Widal test more effectively information like duration of illness, and results from a second sample taken a few days (approximately 2 weeks) later, are important. Significant rise or fall in titre may indicate an acute infection. In countries such as India where infection with typhoidal and non-Typhoidal Salmonella are endemic, a so called “positive” results from a single test may indicate previous exposure to the bacteria in the past, and may not be reflective of recent infection. Also critically important for interpretation is the clinical information- the clinical context of taking the sample, and treatment/vaccination history.

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