Abstract :
Background: Pyrexia of unknown origin (PUO) was described as a persistent fever above 38.3°C (100°F) that evades diagnosis for at least 3 weeks, including 1 week of investigation in hospital. It may be caused by over numerous infectious, rheumatic/ inflammatory, malignant/neoplastic and miscellaneous disorders.
Materials and Methods: Blood specimen of 55 pediatric patients with fever of more than two weeks duration were tested for Typhoid, Rickettsial and Brucella infection serologically. Blood cultures of these patients were tested simultaneously.
Results: Positivity of Immunochromatographic testing for S. Typhi, Widal slide and tube agglutination test was 20%, 23.6% and 21.8% respectively. Titres of >=1:320 were observed in 4 (33.3%) of widal positive patients against H agglutinins. Positivity in Weil-Felix Tube Agglutination test was observed in 1(1.8%) patient against OX-K antigen, in 8 (14.5%) patients against OX-2 and in 6 (10.9%) against OX-19 antigen. Titre of 1:640 was observed in 1(1.82%) of patients against OX-2. One (1.8%) patient showed positive result in Brucella A/M Tube agglutination test.
Conclusion: Although serological investigations provide early and presumptive diagnosis of diseases, clinical features and epidemiological factors play an important role for initiation of treatment where facilities for culture and molecular testing are lacking or the results of the same are negative.
Keyword :
Widal, Typhoid, Rickettsia, Brucella, Pediatric