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Widal Slide Test (4Hrs)

Bacterial/ Viral
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Report in 4Hrs

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At Home

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No Fasting Required

Details

Serological test for typhoid fever by detecting antibodies against Salmonella.

₹149₹330

55% OFF

Widal Slide Test (4Hrs) - Comprehensive Medical Information Guide

  • Why is it done?
    • The Widal Slide Test is a serological diagnostic test designed to detect antibodies against Salmonella typhi and Salmonella paratyphi, the causative agents of typhoid and paratyphoid fever respectively
    • Detects specific antibodies including O (somatic) antigen, H (flagellar) antigen, and AH antigen through rapid slide agglutination methodology
    • Primarily ordered for patients presenting with sustained fever, headache, malaise, abdominal pain, and rose spots indicating suspected enteric fever
    • Commonly performed in endemic regions including South Asia, Africa, and other developing countries with poor sanitation
    • Provides rapid results within 4 hours, making it valuable for quick clinical decision-making in acute settings
    • Used to differentiate between typhoid fever, paratyphoid fever, and other causes of fever in symptomatic patients
    • Often performed during the second to third week of illness when antibody titers are highest and most reliable
  • Normal Range
    • Negative Result: No agglutination visible or titer less than 1:40 or 1:80 (depending on laboratory standards and endemic status)
    • Widal O (O antigen): Normal is less than 1:40 or 1:80; considered positive if ≥1:160 in non-endemic areas or ≥1:320 in endemic areas
    • Widal H (H antigen): Normal is less than 1:40 or 1:80; considered positive if ≥1:160 in non-endemic areas or ≥1:320 in endemic areas
    • Paratyphoid AH: Normal is less than 1:40 or 1:80; positive if ≥1:160 in non-endemic or ≥1:320 in endemic areas
    • Borderline Results: Titers of 1:80-1:160 require clinical correlation and may necessitate repeat testing after 3-5 days
    • Reference ranges vary based on laboratory methodology, endemic status of the region, and prior vaccination history
    • Measurement units: Dilution titers expressed as 1:40, 1:80, 1:160, 1:320, 1:640, or higher
  • Interpretation
    • Positive O antigen (Salmonella typhi) with positive H antigen: Highly suggestive of acute typhoid fever, particularly if O antigen appears before H antigen
    • Positive H antigen alone or with low O antigen: May indicate previous typhoid infection, vaccination, or recovery phase
    • Positive AH antigen (Salmonella paratyphi): Indicates paratyphoid fever or previous paratyphoid infection
    • High rising titers on repeat testing (4-fold rise): More diagnostically significant than single elevated values and supports acute infection
    • All negative results: Does not exclude typhoid fever, especially in early illness (first week) or in vaccinated individuals
    • Factors affecting interpretation: Timing of test in illness course, prior typhoid vaccination, endemic background immunity, antibiotic use, and immunocompromised status
    • False positive results possible in: Malaria, tuberculosis, rheumatoid arthritis, autoimmune diseases, and chronic infections
    • False negative results may occur in: Early infection (first week), immunocompromised patients, previous typhoid with waning antibodies, or overwhelming infection
    • Clinical significance: Must be interpreted alongside clinical presentation, blood culture results, and other laboratory findings for accurate diagnosis
  • Associated Organs
    • Primary organ systems: Gastrointestinal tract, liver, spleen, lymphoid tissue, and bloodstream as route of systemic infection
    • Enteric Fever (Typhoid and Paratyphoid Fever): Systemic infection caused by Salmonella typhi and paratyphi, primary diagnosis this test identifies
    • Hepatic involvement: Risk of hepatitis, cholecystitis, and biliary complications; chronic carriers may develop gallstones
    • Splenic complications: Splenomegaly, splenic rupture (rare but life-threatening), and splenic abscess formation
    • Intestinal complications: Intestinal perforation, toxic megacolon, gastrointestinal hemorrhage, and peritonitis
    • Cardiovascular involvement: Myocarditis, shock, and arrhythmias in severe cases
    • Neurological complications: Encephalopathy, delirium, meningitis, and neuritis in severe untreated cases
    • Bone and joint involvement: Osteomyelitis and septic arthritis, particularly in bacteremia complications
    • Chronic carrier state: Persistent infection in gallbladder and urinary tract; 1-5% of patients become chronic carriers
    • Untreated disease risks: Death rates of 20-40% without appropriate antibiotic therapy, with mortality increasing with delayed diagnosis
  • Follow-up Tests
    • Blood Culture: Gold standard for typhoid diagnosis; performed in acute febrile illness for bacterial isolation and antimicrobial susceptibility testing
    • Repeat Widal Slide Test (3-5 days later): Recommended if initial results are borderline or negative but clinical suspicion remains high
    • Urine Culture: Useful for identifying chronic carriers or in patients with urinary tract involvement
    • Stool Culture: Important for identifying chronic carriers and for epidemiological surveillance
    • Bone Marrow Culture: Most sensitive test (90%) for typhoid diagnosis, particularly useful in treated patients or early illness
    • Polymerase Chain Reaction (PCR): Emerging rapid molecular diagnostic test for Salmonella typhi identification
    • Complete Blood Count: To assess for leukopenia, anemia, and thrombocytopenia common in typhoid
    • Liver Function Tests: Elevated transaminases, bilirubin, and alkaline phosphatase in hepatic involvement
    • Renal Function Tests: To monitor kidney involvement and guide antibiotic dosing in severe disease
    • Abdominal Imaging (Ultrasound/CT): If complications suspected (intestinal perforation, splenomegaly, splenic rupture, or cholecystitis)
    • Antimicrobial Susceptibility Testing: Essential for appropriate antibiotic selection based on culture isolate
  • Fasting Required?
    • Fasting Required: No - The Widal Slide Test does not require fasting and can be performed at any time of the day
    • Blood Sample Collection: A simple venipuncture for serum or plasma sample is required; no special preparation is necessary
    • Medications: No medications need to be discontinued before this test; continue all regular medications as prescribed
    • Antibiotic Consideration: Ideally, blood should be drawn before starting antibiotic therapy, as antibiotics may reduce bacterial recovery in culture
    • Timing in Illness: Test is most reliable when performed during the second to third week of illness for optimal antibody detection
    • Patient Preparation: No special preparation required; patient should arrive for blood collection in normal state
    • Sample Handling: Blood sample should be collected in appropriate collection tube (typically SST or EDTA based on laboratory protocol)
    • Sample Transport: Samples should be transported to the laboratory promptly to maintain optimal antibody integrity

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