Typhoid fever is suspected based on the signs and symptoms. Your doctor will recommend tests to confirm the diagnosis.
The diagnosis is usually confirmed by identifying the causative bacteria S. typhi in a culture of your blood or other body fluid or tissue. Your doctor will take a small sample of your blood, stool, urine or bone marrow. The sample is then placed on a special medium that encourages the growth of S. typhi. This culture is examined 48 to 72 hours later under a microscope to detect for presence of typhoid bacteria. Bone marrow culture is considered the most sensitive test for S. typhi.
This test is used for the diagnosis of typhoid fever with variable success. The test has good sensitivity and specificity but it is not widely available for clinical diagnosis of typhoid fever.
This test measures agglutinating antibodies against H and O antigens of S typhi and was the mainstay of typhoid fever diagnosis for decades. But as it is not a sensitive or specific test it is no longer used for diagnosis of typhoid fever.
Culture is considered as the gold standard for diagnosis of typhoid fever but your doctor may recommend other tests to confirm a suspected typhoid infection. Some other tests which are used include indirect hemagglutination, indirect fluorescent Vi antibody, and indirect enzyme-linked immunosorbent assay (ELISA) for immunoglobulin M (IgM) and IgG antibodies to S typhi polysaccharide, as well as monoclonal antibodies against S typhi flagellin. These tests try to detect antibodies or antigen of typhoid bacteria in your blood or S.typhi DNA in a blood sample. But most of these tests are not used widely for clinical diagnosis of typhoid fever.
If you have symptoms suggestive of typhoid fever consult your doctor for diagnosis and treatment. Prognosis of typhoid fever with appropriate antibiotics is good.
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