Bone marrow culture versus widal tests in the diagnosis of typhoid fever as a cause of fever of undetermined origin

Widal tests are widely used in the routine work-up of febrile patients. Most of the patients with typhoid fever are diagnosed early in their course and only a few, especially partially treated patients' become FUO. cases. In such patients the yield of Widal tests and early blood culture is little, if any. This is due to undue antibiotic trial for any febrile patient. Repeated Widal tests are usually part of routine investigations in a patient with FUO, but it seems that most of these tests are useless. It appears that only two widal are justified, one performed prior to labelling a patient an FUO and another in the second week of investigations. In addition it must be remembered that early bone marrow culture and repeated blood cultures later in the hospital course are the mainstay of the diagnosis of typhoid in FUO