Typhoid cases rise 65%; docs flag diagnostic test dilemma
Dr Ameet Dravid, infectious disease specialist from Noble and Poona hospitals, said, "The ideal test for typhoid in the first week is a blood culture, but many practitioners are relying on Widal, an antibody-based extremely non-specific test."
Experts said the Widal test could yield false positives for any fever. "Despite its unreliability, Widal remains the most commonly prescribed diagnostic tool for typhoid in the first week of illness.
The situation is further complicated by random antibiotic prescriptions even before proper diagnosis," Dr Dravid said, recommending junking Widal altogether.
You Can Also Check:
Pune AQI
|
Weather in Pune
|
Bank Holidays in Pune
|
Public Holidays in Pune
"Blood culture is the gold standard test. It will come positive in 50-80% of cases if done prior to giving antibiotics as its sensitivity goes down drastically once the antibiotic is given," he said.
The use of incorrect diagnostic test leads to uncertainty in diagnosis, resulting in physicians prescribing unnecessary stronger antibiotics.
by Taboola
by Taboola
Sponsored Links
Sponsored Links
Promoted Links
Promoted Links
You May Like
No annual fees for life
UnionBank Credit Card
Apply Now
Undo
"When the non-specific test results are inconclusive, practitioners often treat for upper respiratory tract infections. The fever in such cases lasts for around 20 days, after which patients land up with infectious disease consultants," Dr Dravid said.
Dr Piyush Chaudhary, infectious disease specialist at Jehangir Hospital, said, "During monsoon, we see a significant number of typhoid cases. Yet, this infection often gets missed in the first 5–7 days because of empirical treatment without proper diagnostics like blood cultures."
He said, "Typhoid typically doesn't cause a rise in white blood cells, so unless there's strong clinical suspicion, it can be overlooked... Blood culture is underused because its results take time, making doctors to rely on Widal test, which is highly unreliable."
Dr Awanti Golwilkar-Mehendale, director and chief of laboratory at Pune-based AG Diagnostics, said the choice of typhoid test depended on the stage of illness and prior antibiotic use.
"Widal tests aren't ideal for early diagnosis. However, if antibiotics have been taken, blood culture results may be unreliable. So, Widal tests might be used later for confirmation. Typhi IgM tests can occasionally yield false positives, making follow-up testing with Widal or blood culture necessary.
Additionally, PCR-based tests can be used for early diagnosis," she said.
The experts said Widal could be falsely negative in half of true typhoid cases, and falsely positive in half of those who don't have the disease.
"In many referred cases, we found that the illness had already progressed as the initial testing was flawed or the patient was put on antibiotics before any diagnostic workup," Dr Chaudhary said.
Dr Mahesh Kumar Lakhe, infectious disease expert at Sahyadri Hospitals, said, "Typhoid is a bacterial infection transmitted through contaminated food and water, typically via the fecal-oral route. Eating raw salads, improperly stored food or undercooked milk products can all lead to infection."
Blood culture requires an adequate blood sample (ideally 8-10ml) and the organism may take 4-7 days to grow. "We're seeing a number of referrals with prolonged undiagnosed fever. These are often typhoid cases where diagnosis was delayed because the initial physician didn't suspect it or used unreliable tests," Dr Lakhe said, adding, "This season, we are seeing a higher number of 'Salmonella paratyphi A' cases in our lab-confirmed cultures, which tend to have a more prolonged fever course compared to the classic 'S typhi' strain.
"
Dr Nikhil Phadke, founder-director and chief science officer at GenePath Diagnostics, said while Widal was commonly requested, it was often done using the slide method, which was less reliable than the preferred tube method. "We get very few culture requests," he said, adding that cultures take time while antibody tests (like Widal) give faster results, which influences clinical decisions.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Time of India
18 minutes ago
- Time of India
PGI performs groundbreaking brain tumour surgery on 2-year-old girl
1 2 Chandigarh: A team of neurosurgeons at PGI successfully performed a groundbreaking brain surgery on a two-year-old girl from Amroha, Uttar Pradesh, who was losing her vision. The doctors removed a giant 4.5 cm brain tumour through the child's nose, a procedure considered one of the most challenging in paediatric neurosurgery. Dr S S Dhandapani, who led the team, previously published the first report in the world on endonasal surgery for craniopharyngioma—surgery for the removal of a brain tumour of size 3.4 cm at 16 months of age. "But tumours larger than 4 cm, called giant tumours, have never undergone surgery through the nose at 2 years of age, except once before at Stanford," said Dr Dhandapani. The young patient arrived at the hospital with significant vision loss in both eyes and hormonal deficiencies. An MRI scan revealed a massive tumour, a craniopharyngioma, lodged deep at the base of her brain, close to critical structures like the optic nerves and hypothalamus. While the standard treatment for such tumours involves opening the skull, this approach was too risky for a child so young. The surgical team opted for a highly advanced endoscopic endonasal surgery — a procedure where surgeons navigate through the nasal passages to reach the tumour. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Dolly Parton, 79, Takes off Her Makeup and Leaves Us Without Words The Noodle Box Undo This approach avoids cutting into the skull and retracting the brain, significantly reducing recovery time and potential damage. However, performing this surgery on a small child less than 4 years of age is challenging. "The child's nasal corridors are tiny, the bones at the skull base are still immature, and vital blood vessels are in close proximity. We had to make holes close to the carotid artery—major blood vessels in the neck that supply oxygenated blood to the brain, face, and neck," said the neurosurgeon. Over a gruelling six-hour operation, the team, which included ENT surgeon Dr Rijuneeta, utilised a thin, high-definition endoscope and computer navigation to meticulously create a path to the tumour. With a combination of specialised micro-instruments and extensive drilling of immature bones, they carefully dissected the tumour from the delicate neural structures and removed it piece by piece through the nose. Just 10 days later, a CT scan confirmed the near-total removal of the tumour, and the young girl is now stable. "But we have to wait for the restoration of her vision, which was lost before the surgery due to the delay in coming to us," said Dhandapani.
Time of India
an hour ago
- Time of India
Christina Applegate hospitalized: Inside her double kidney infection amid MS struggles (symptoms, risk factors, treatment)
Christina Applegate, the 53-year-old actress known for Dead to Me and Married… with Children, has been hospitalized in Los Angeles after a painful kidney infection spread to both kidneys. While visiting family in Europe, she began feeling unwell, then suffered excruciating pain during her return flight. She checked into a hospital immediately and underwent an emergency CT scan, which confirmed the infection. The painful crisis comes amid her ongoing battle with multiple sclerosis (MS), a chronic nerve condition she's openly shared since her diagnosis in 2021. What happened While visiting family in Europe, Applegate began feeling unwell. Rather than wait it out, she sought immediate care upon returning to Los Angeles. She described intense pain, sudden onset on her right flank, radiating from back to front, so severe she thought her appendix might burst. An emergency CT scan at 2 a.m. confirmed the diagnosis: a serious kidney infection that had spread from her right kidney to her left. Doctors initially suspected a urinary tract infection (UTI), but the CT revealed a deeper, more dangerous infection. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like This new air conditioner cools down a room in just seconds News of the Discovery Undo What is MS and how it affects Applegate's health Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system, specifically the brain and spinal cord. In MS, the immune system mistakenly attacks the myelin sheath, a protective covering of nerve fibers, causing inflammation and damage. This damage disrupts the communication between the brain and the rest of the body, leading to a wide range of neurological symptoms. To break it down a bit more… In MS, the body's immune system, which normally fights off infections, mistakenly attacks the myelin sheath that insulates nerve fibers in the brain and spinal cord. Central nervous system: The central nervous system (CNS) is comprised of the brain and spinal cord, which are crucial for controlling bodily functions and transmitting messages. Myelin damage: The myelin sheath acts like insulation on electrical wires, allowing nerve impulses to travel efficiently. When the myelin is damaged (demyelination), it disrupts the signals, causing a variety of neurological symptoms. Scar tissue formation: As the myelin is damaged, scar tissue (sclerosis) may form in the CNS, further interfering with nerve signal transmission. MS is unpredictable, and symptoms can fluctuate over time, with periods of relapse (worsening of symptoms) and remission (improvement). Applegate, diagnosed with multiple sclerosis in 2021, has shared that MS has caused more than 30 hospital stays due to gut motility issues, vomiting, and diarrhea. MS can slow down organ function, including the bladder and kidneys, raising the risk of UTIs and serious infections. When the immune system is stressed and nerve communication is impaired, fighting infections becomes harder, a major concern for Applegate. Symptoms of MS Multiple Sclerosis (MS) symptoms vary widely but can include vision problems, numbness or tingling, muscle weakness and spasms, fatigue, cognitive changes, and bowel or bladder dysfunction. Symptoms can fluctuate and are often worse with heat or fever, according to the National Institute of Neurological Disorders and Stroke . Common symptoms include: Vision problems: Blurred or double vision, optic neuritis (painful vision loss), color distortion. Numbness and tingling: Can occur in the limbs, face, or other areas. Muscle weakness and spasms: Can affect walking, standing, and overall mobility. Fatigue: Can be debilitating and persistent. Cognitive changes: Problems with concentration, memory, and decision-making. Bowel and bladder dysfunction: Incontinence or difficulty with urination and bowel movements. Pain: Can include sharp, shooting pains or muscle spasms. Speech problems: Slurred speech or difficulty speaking clearly. Dizziness and balance problems: Can affect coordination and gait. Depression: Can be a common symptom or a secondary consequence. Sexual problems: Difficulty with arousal or maintaining an erection in men and decreased enjoyment in both men and women. MS symptoms can be relapsing-remitting (periods of relapse and remission) or primary progressive (gradual worsening). It's important to note that these symptoms can be similar to other neurological conditions, so a proper diagnosis is crucial. Risk factors Multiple Sclerosis (MS) is a complex disease influenced by a combination of genetic and environmental factors. Key risk factors include age, sex, family history, certain infections, race, climate, vitamin D levels, obesity, smoking, and potentially the gut microbiome. Let's take a detailed look: Age: Onset typically occurs between 20 and 40 years of age, though it can occur at any age. Sex: Women are 2 to 3 times more likely than men to develop relapsing-remitting MS. Family history: Having a first-degree relative with MS increases the risk of developing the disease. Certain infections: Exposure to viruses like Epstein-Barr virus (EBV) is a strong risk factor. Race: People of white (particularly Northern European) descent have a higher risk. Climate: MS is more common in regions with temperate climates (further from the equator). Vitamin D: Low levels of vitamin D and limited sun exposure are associated with increased risk. Obesity: Obesity, especially in childhood, is a risk factor. Smoking: Smoking increases the risk of developing MS and can worsen the disease. Gut microbiome: Individuals with MS may have a different gut microbiome composition. Moreover, having other autoimmune conditions can slightly increase MS risk. Treatment Since there is no cure for the disease yet, treatment for multiple sclerosis (MS) focuses on managing symptoms, slowing disease progression, and improving quality of life. Treatment approaches include disease-modifying therapies (DMTs) to reduce relapses and slow progression, medications for specific symptoms, and rehabilitation therapies. Disease-modifying therapies (DMTs): Injectable medications: These include interferon-beta and glatiramer acetate. Oral medications: Examples include dimethyl fumarate, fingolimod, teriflunomide, and siponimod. Infusion therapies: Examples include natalizumab, ocrelizumab, and alemtuzumab. Treating relapses: Corticosteroids: Intravenous or oral corticosteroids can be used to reduce inflammation and shorten the duration of relapses. Plasma exchange (plasmapheresis): This is an option when corticosteroids are not effective. Symptom management: Muscle relaxants: To reduce muscle stiffness and spasms (e.g., baclofen, tizanidine). Fatigue management: Exercise, healthy sleep patterns, and avoiding medications that worsen fatigue. Pain management: Various medications like amitriptyline, pregabalin, and gabapentin. Bladder and bowel problems: Medications and other therapies to manage these symptoms. Cognitive and emotional issues: Medications and therapies to address depression, anxiety, and cognitive problems. Rehabilitation therapies: Physical therapy: To improve mobility, balance, and coordination. Occupational therapy: To help with daily living activities and adaptive equipment. Speech therapy: For communication and swallowing difficulties. Some other considerations: Stem cell transplant: This is a more intensive treatment option for some individuals, involving the removal, treatment, and replacement of a person's own cells to reset the immune system, according to Mass General Brigham . Nutritional counseling: To support overall health and well-being. Multidisciplinary approach: Working with a team of healthcare professionals, including neurologists, physical therapists, and other specialists, is essential for comprehensive care. In the case of Applegate, the actress has reportedly been receiving intravenous antibiotics (IV) around the clock, which is standard for bilateral kidney infections. She remained hospitalized for a week, undergoing extensive testing to ensure a correct diagnosis and rule out other conditions. Her goal: exhaustive testing until she fully understands what's triggering her intense pain and symptoms.
Time of India
an hour ago
- Time of India
One mission to feed babies: TN woman donates 300 litres of breast milk in 22 months; saves sick newborns, sets record
TRICHY: Two kids at home. A breast pump by her side and 300 litres of mother's milk. One mission - to feed babies she would never meet. Selva Brindha, 33, a homemaker from Kattur in Trichy district, has donated 300.17 litres of breast milk over 22 months, helping save the lives of countless premature and sick newborn babies. Her effort, supported by an NGO, earned her entries in both Asia Book of Records and India Book of Records. Her contributions - made between April 2023 and Feb 2025 - accounted for nearly half of the total donor milk collected by Trichy's Mahatma Gandhi Memorial Govt Hospital milk bank in 2023-24. "It wasn't easy at first. I lost weight and faced scepticism," Brindha said. "But once I learned that pumping milk burns calories and doesn't harm health, I kept going. Over time, I grew emotionally connected to the cause." The journey began in 2023 after her daughter required neonatal intensive care, where babies rely on donor milk for survival and growth. Brindha saw first-hand how vital breast milk was to recovery. Once her supply outpaced her child's needs, she began donating - eventually making one of the largest known individual contributions to a govt milk bank in India. A newborn typically needs 20ml to 40ml of milk, 10 to 12 times a day. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Emergency Generators in Crucita: (Prices May Surprise You) Emergency Generator | Search Ads Search Now Undo Brindha's donations potentially fed thousands of babies. "She has set an extraordinary example," said Dr S Padmapriya, paediatrician and in-charge of the hospital's milk bank. "We will honour her during our World Breastfeeding Week valedictory function on Aug 7." Brindha was supported throughout by her family. "Even a small contribution can nourish a baby who desperately needs it. That thought alone should move people to act," she said. She also called for breaking the silence and taboos surrounding breast milk donation. "Once people understand it's about saving lives, the hesitation fades," she said.
