Title: Clinically detected Enteric Fever in Children – Blood Culture as a Diagnostic Aid

Authors: Dr Kanai Lal Barik, Dr Rituparna Bhattacharya, Dr Uttam Kumar Paul, Dr Arup Bandyopadhyay

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i4.199

Abstract

Enteric fever is considered a globally threatening disease in several developing countries, caused by the bacterium “Salmonella enterica serovar Typhi”. Taking diagnosis into concern, blood culture technique is the most reliable diagnostic method, but is complicated and time consuming to be applicable in developing countries, especially in remote places and villages. In such unfavorable circumstances, we attempted to understand the current feasibility of blood culture as a diagnostic aid in clinically detected enteric fever patients in children population below 12 year age group to gain insight in order to develop better diagnostic strategies in the future. A total of 151 patients, of both sexes, below 12 years of age with fever of 3 or more days without any history of antibiotic therapy were included for the study. Blood sample was collected from each patient, and culture was carried out for salmonella using media, the results analyzed thereafter. The results showed that out of 151 clinically detected enteric fever patients, 43 (28%) were positive for typhoid (S.typhi) and 19 (12%) were positive for paratyphoid A (S.paratyphi A). 62 patients showed positive blood culture results, i.e. ~  40% of the patients.

Thus the mass inaccurate diagnosis and empirical therapy practiced within the community is largely unacceptable. Proper control measures and better diagnostic strategies are warranted for the effective management of this medically and socially devastating malady.

Keywords:  Enteric Fever, Diagnostic Aid, Blood Culture, Children. 

References

1.      Wain J, Hendriksen RS, Mikoleit ML, Keddy KH, Ochiai RL. Typhoid fever. The Lancet. 21 March, 2015; 385(9973): 1136-1145.

2.      Christopher MP, Hien TT, Dougan G, Nickolas JW, Farrar JJ. Typhoid fever. NEJM 2002; Nov,28; 347(22): 1770-1782.

3.      Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ 2004; 82: 346-53.

4.      Buckle GC, Walker CL, Black RE. Typhoid fever and paratyphoid fever: systemic review to estimate global morbidity and mortality for 2010. J Glob Health 2012;2:10401.

5.      Andualem G, Abebe T, Kebede N, Gebre-Selassie S, Mihret A, Alemayehu H. A comparative study of Widal test with blood culture in the diagnosis of typhoid fever in febrile patients. BMC Res Notes, 2014; 7: 653.

6.      Khanam F, Sheikh A, Sayeed MA, et al. Evaluation of a typhoid/paratyphoid diagn-ostic assay (TP Test) detecting anti-salmonella IgA in secretions of peripheral blood lymphocytes in patients in Dhaka, Bangladesh. Plos Negl Trop Dis 2013; 7: e2016.

7.      Dutta S, Sur D, Manna B, et al. Evaluation of new-generation serologic tests for the diagnosis of typhoid fever: data from a community based surveillance in Calcutta, India. Diagn Microbiol Infect Dis 2006; 56: 359-65.

8.      Ley B, Thriemer K, Ame SM, et al. Assessment and comparative analysis of a rapid diagnostic test (Tubex®) for the diagnosis of typhoid fever among hospitalized children in rural Tanzania. BMC Infect Dis. 2011; 11: 147.

9.      Keddy KH, Sooka A, Letsoalo ME, et al. Sensitivity and specificity of typhoid fever rapid antibody tests for laboratory diagn-osis at two sub-Saharan African sites. Bull World Health Organ. 2011; 89: 240-47.

10.  Paul UK, Barik KL, Sinharay K, Banik S, Bandyopadhyay A. Knowledge, Attitude and Practice of General Practitioners Regarding Typhoid Fever. Int J Sci Stud. January 2016; 3(10): 1-4.

11.  Bhattacharya P, Saha BK, Paul UK, Bandyopadhyay A. Blood Culture in Clinically Suspected Typhoid Fever. Int J Sci Stud. 2017; 4(11): 1-4.

12.  Stuart BM, Pullen RL. Typhoid; clinical analysis of 360 cases. Arch Intern Med (Chic) 1946; 78: 629-61.

Corresponding Author

Dr Uttam Kumar Paul

Prayas, Dr. B. C. Roy Sarani, P.O - Raiganj, Dist. – Uttar Dinajpur

West Bengal, India Pin 733134

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile no.: 9434041237