LUCKNOW: As many as 40 cases were reported in Balrampur (15) and Lokbandhu (25) hospitals in the last 15 days, in which the Widal test, a method of diagnosis of enteric fever or typhoid fever, was positive.
However, on closer investigation, it was found that these were cases of viral fever or dengue.
Dr Ajay Kumar Tripathi, chief medical superintendent, Lok Bandhu hospital, said, “Since patients had high grade fever, head and muscle pain but specific symptoms of typhoid like diarrhoea, vomiting, acute constipation were missing we ruled out the possibility of typhoid and treatment for dengue was given. Patients recovered in five days without any medication given for typhoid.”
Similarly, many such cases have also come to the fore in private hospitals and clinics. TOI found some cases in which typhoid treatment was given without symptoms due to misdiagnosis.
Balrampur hospital, Dr Narendra Deo informed it is the season for high grade fever and prescription of quick presumptive tests by doctors to profile fever -- dengue, malaria, typhoid, flu and chikungunya tests -- is causing the confusion. “We have also witnessed 10 such viral fever cases in which Widal was false positive,” he added. Since Widal is not a confirmatory test for typhoid, a clinician should rely on clinical symptoms, he advised.
Explaining why Widal comes false positive in many cases, ex-president, Private Pathologists Association, Dr PK Gupta, said it detects antibodies against Salmonella Typhi, a bacterium that causes Typhoid. “In India, we are exposed to this bacteria by consuming contaminated water and unhygienic food. Hence, the body creates antibodies to kill bacteria and prevent infection. These antibodies remain dormant in the body and when Widal test is done, they often get detected,” he added.
Doctors should correlate the reports with clinical symptoms and send a blood sample for culture to confirm typhoid. If a rapid result is required, Typhidot-M can be done, suggested former head, microbiology, IMS BHU, prof Anil Kumar Gulati.
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