Comparison of blood, bone marrow aspirate, stool and urine cultures in the diagnosis of enteric fever.

A total of 288 specimens made up of 84 specimens each of blood, stool, urine and 36 specimens of bone marrow aspirates were collected from enteric fever patients. The blood specimen was used for cultural diagnosis and malaria parasite (MP) test, while serum from the blood was screened by Widal test. The remaining specimens (bone marrow aspirate, stool and urine) were only used for cultural diagnosis, but their cultural diagnostic sensitivity were only calculated from the patients whose Widal tests were positive. The widal test showed that 21(25%) had significant reciprocal titre levels of > 80 and > 160 for O and H antigens respectively. Malaria parasites test also had 23(37.4%) cases positive with 1(4.4%) and 22(95.7%) of them positive and negative by widal test respectively. Stool, blood and bone marrow aspirate were 33%, 28.6% and 38.1% sensitive respectively, while the diagnostic sensitivity of urine was zero. In the diagnosis of enteric fever, it is suggested that the presumptive serology test (Widal) be carried out along with cultures from bone marrow aspirate and stool where the former is affordable and available. Malaria parasite microscopy should also be done because majority of the suspected enteric fevers may actually only be malaria fever in an environment like Nigeria which is endemic for the two diseases (malaria and typhoid fever).