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The Laboratory Diagnosis of Typhoid Fever in Areas of Endemicity

A study of cultural and serological methods of diagnosis in a series of 227 cases of typhoid fever demonstrated that the former methods were to be preferred. In particular culture of blood clot is a more satisfactory procedure than culture of whole blood. Our total recovery rate from blood culture methods was 89%, and this in spite of many patients having received antibiotic therapy before blood samples were taken. Accepting a serum dilution of 1/250, for O type agglutination, as being the minimal suggestive titer we found 5% false positive reactions. Twenty eight per cent negative results were obtained. Reasons are discussed for accepting the figure of 1/250 minimal dilution of serum as being suggestive of infection in this area.