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False-positive widal in melioidosis.
Indian J Med Sci. 2009 Oct; 63(10):464-7.IJ

Abstract

Enteric fever is endemic in this part of the world, and Widal test is one of the time-honored laboratory tests that are being used for years to diagnose the disease. On the other hand, melioidosis is a newly emerging disease from this region, which is most often misdiagnosed or underdiagnosed by clinicians. It is well accepted that false-positive Widal reactions following certain non-typhoid Salmonella infections may occur commonly. Three cases of high titers of Widal test are described, where melioidosis was the actual diagnosis in every occasion and was never suspected until diagnosed microbiologically. All the patients had shown a partial response to ceftriaxone. Blood and pus cultures grew Burkholderia pseudomallei, whereas Salmonella typhi was not isolated from blood in any patient. With appropriate antibiotics, the patients showed clinical and microbiological improvement with lowering of Widal titers. These 3 cases show that high Widal titer in any patient may mislead the diagnosis of melioidosis, and further laboratory workup should always be done to rule out melioidosis, especially in cases with nonresponsiveness to treatment.

Authors+Show Affiliations

Department of Medicine, Kasturba Medical College, Manipal, India. drrohithv@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19901486

Citation

Valsalan, Rohith, et al. "False-positive Widal in Melioidosis." Indian Journal of Medical Sciences, vol. 63, no. 10, 2009, pp. 464-7.
Valsalan R, Shubha S, Mukhopadhyay C, et al. False-positive widal in melioidosis. Indian J Med Sci. 2009;63(10):464-7.
Valsalan, R., Shubha, S., Mukhopadhyay, C., Saravu, K., Maneesh, M., Shastry, B. A., Rau, N. R., Pandit, V. R., & Gonsalves, H. (2009). False-positive widal in melioidosis. Indian Journal of Medical Sciences, 63(10), 464-7. https://doi.org/10.4103/0019-5359.57647
Valsalan R, et al. False-positive Widal in Melioidosis. Indian J Med Sci. 2009;63(10):464-7. PubMed PMID: 19901486.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - False-positive widal in melioidosis. AU - Valsalan,Rohith, AU - Shubha,S, AU - Mukhopadhyay,C, AU - Saravu,K, AU - Maneesh,M, AU - Shastry,B A, AU - Rau,N R, AU - Pandit,V R, AU - Gonsalves,Hazel, PY - 2009/11/11/entrez PY - 2009/11/11/pubmed PY - 2011/6/3/medline SP - 464 EP - 7 JF - Indian journal of medical sciences JO - Indian J Med Sci VL - 63 IS - 10 N2 - Enteric fever is endemic in this part of the world, and Widal test is one of the time-honored laboratory tests that are being used for years to diagnose the disease. On the other hand, melioidosis is a newly emerging disease from this region, which is most often misdiagnosed or underdiagnosed by clinicians. It is well accepted that false-positive Widal reactions following certain non-typhoid Salmonella infections may occur commonly. Three cases of high titers of Widal test are described, where melioidosis was the actual diagnosis in every occasion and was never suspected until diagnosed microbiologically. All the patients had shown a partial response to ceftriaxone. Blood and pus cultures grew Burkholderia pseudomallei, whereas Salmonella typhi was not isolated from blood in any patient. With appropriate antibiotics, the patients showed clinical and microbiological improvement with lowering of Widal titers. These 3 cases show that high Widal titer in any patient may mislead the diagnosis of melioidosis, and further laboratory workup should always be done to rule out melioidosis, especially in cases with nonresponsiveness to treatment. SN - 1998-3654 UR - https://www.unboundmedicine.com/medline/citation/19901486/False_positive_widal_in_melioidosis_ DB - PRIME DP - Unbound Medicine ER -