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Duodenal string test in typhoid fever

T J Antony1, A K Patwari, V K Anand

  • 1Department of Pediatrics, Lady Hardinge Medical College, New Delhi.

Indian Pediatrics
|May 1, 1993
PubMed
Summary
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The duodenal string-capsule culture (DSCC) is a practical and sensitive method for diagnosing enteric fever in children. This non-invasive test, when combined with blood cultures, significantly improves pathogen detection rates.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Gastroenterology

Background:

  • Enteric fever, primarily caused by Salmonella Typhi, remains a significant public health concern, particularly in children.
  • Accurate and timely diagnosis is crucial for effective treatment and preventing complications.
  • Conventional diagnostic methods like blood, urine, and stool cultures have limitations in sensitivity and practicality.

Purpose of the Study:

  • To evaluate the practicality and sensitivity of the duodenal string-capsule culture (DSCC) for diagnosing enteric fever in hospitalized children.
  • To compare the diagnostic yield of DSCC with conventional culture methods (blood, urine, stool).

Main Methods:

  • A study involving 25 children (4-12 years) diagnosed with enteric fever.

Related Experiment Videos

  • Successful insertion of the duodenal string-capsule in 18 patients (72%).
  • Comparison of DSCC results with blood culture (BC), urine culture (UC), and stool culture (SC).

    • Main Results:

    • DSCC successfully isolated Salmonella Typhi in 11 out of 13 confirmed cases (84.6%), demonstrating high sensitivity.
    • DSCC identified the pathogen in approximately 30% more cases than blood cultures alone (61.5%).
    • DSCC insertion failure occurred in 7 patients (28%), exclusively in those younger than 6 years.

    Conclusions:

    • Duodenal string-capsule culture is a simple, non-invasive, and reliable diagnostic tool for enteric fever in children.
    • Combining DSCC with blood cultures enhances the overall detection rate of enteric fever, regardless of fever duration or prior antibiotic use.
    • The DSCC method shows promise for improving the diagnosis of enteric fever, especially in pediatric populations.