Typhoid fever: clinical diagnosis versus laboratory confirmation

Recently there has been an increase in the clinically diagnosed typhoid fever in various parts of Nigeria with subsequent increase in public fear of possible epidemics of the disease. In this study the accuracy of clinically diagnosed typhoid fever were investigated.

Blood and stool specimens from 260 patients clinically diagnosed typhoid fever were investigated using Widal test and bacteriological culture methods respectively.

One hundred and thirty-four (51.5%) of the cases investigated were positive and that there was a significant difference (P < 0.05) between the clinically diagnosed and bacteriologically confirmed typhoid fever cases. Causative organisms were Salmonella typhi 46 (34.3%); S paratyphi B 34 (25.4%); S paratyphi A 24 (17.9%); S paratyphi C 20 (14.9%); other Salmonella spp 10 (7.5%). Young adults and males were predominantely affected.

Most of the clinically diagnosed typhoid cases were misdiagnosis and the hue and cry by the general public on the epidemic of typhoid fever could not be justified. It is recommended that careful detailed history taking, meticulous clinical examination and prompt bacteriological culturing of specimens from suspected typhoid cases will improve the accuracy of clinically diagnosed typhoid fever.