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Had Typhoid, Done Widal Test. What Does Report Indicate?

Posted on Wed, 16 Oct 2013

Question: Hi..

My wife Widal test report shows Salmonella Typhi O and H are given as "Agglutination in < 1:80 dilution" & Salmonella Paratyphi 'AH' and 'BH' as "No Agglutination seen". Doctor whom we showed is saying as symptoms of Thyphoid . She got effected with Thyphoid in the past.( May and July (weakly positive) this year). Fever wise she is not getting much , temp's we are seeing as 99.5 (max).

Do we need to consider this as Thyphoid ,Please let me know your suggestion and what action we should take next ?

Answered by Dr. Polash Sannigrahi (1 hour later)

Brief Answer:
Not to considered Typhoid on basis of Widal only

Detailed Answer:
Hello XXXXXXX

Thanks for your query.

The condition may not be considered as Typhoid on basis of Widal test only due to the following reasons:

1. According to the Widal test reports, S typhi O and H: <1:80 & Salmonella paratyphi 'AH' and 'BH': "No Agglutination seen"
This indicates the antibody to S typhi is present. But a titer of <1:80 is very less & is not considered significant.
Widal test is considered positive if TO antigen titer is more than 1:160 in presence of active infection.
Moreover, a single Widal test is usually not significant.
And a repeat test has to be done for comparison of the values to determine the presence of infection & success of the treatment.

If the repeat test shows an increased titers, then it is considered significant & treatment has to be started with antibiotics.

2. Moreover, she is not getting much fever as mentioned in your post.
The mild increase in body temperature can be attributed to the Thyroid hormone supplement ELTROXIN which increases the metabolic rate with resulting heat production in the body.
So, kindly discuss with her treating physician regarding the same.

There is no need to worry, your wife will be fine.
Make sure she maintains adequate nutrition & hydration status & avoids stress.
Wishing her a good health.
Please let me know if I need to clarify further.
Thanks & take care.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Polash Sannigrahi (2 hours later)

Thanks Doctor !

If we do blood culture test , will that confirm if she has any thyphoid issue.
I think blood culture is the ultimate test which will confirmly say about thyphoid issue. Please let us know !

Answered by Dr. Polash Sannigrahi (10 hours later)

Brief Answer:
Kindly view the details

Detailed Answer:
Hello XXXXXXX

Thanks for your follow up query.

The following tests are carried out for the diagnosis of Typhoid fever, based on the duration of symptoms.

1. 1st week: Blood culture
2. 2nd week: Antigen antibody test (Widal test)
3. 3rd week: Stool culture
4. 4th week: Urine culture

So, if the infection is in the beginning stage, blood culture will be of more help than Widal test.
As Widal test is based on the presence of antigen-antibody relationship, but Blood culture will directly show the presence or absence of the causative organism.

Hope I have been able to answer your query.
If you have additional questions or follow up queries then please do not hesitate in writing to us.
I will be happy to answer them.
Take care.

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Above answer was peer-reviewed by : Dr. Raju A.T