Question
Name the causative agents of enteric fever. Discuss the laboratory diagnosis (2+4)
Q8 6 marks Short Essays ★ ✓
Answer
Causative agents of enteric fever : Salmonella enterica serovar Typhi (typhoid fever), and serovars Paratyphi A, B, and C (paratyphoid fever).
Laboratory diagnosis :
Blood culture — the gold standard test; most sensitive in the first week of illness during the bacteraemic phase; sensitivity declines with disease progression and with prior antibiotic use.Bone marrow culture — the single most sensitive test overall, remaining positive even later in the illness or after antibiotics have been started, since organisms persist longer within reticuloendothelial cells.Stool and urine culture — become positive from the second/third week onward, useful for identifying carriers, though less sensitive for acute diagnosis.Widal test — detects agglutinating antibody against Salmonella O and H antigens; meaningfully positive from around the second week; a single titre has limited value due to cross-reactivity and background seropositivity in endemic areas — a four-fold rise in titre between paired acute and convalescent sera is the most reliable serological evidence.Rapid immunochromatographic tests (e.g., Typhidot, IgM dipstick) — detect specific antibody, provide rapid results, useful as point-of-care screening tools.Molecular methods (PCR) — increasingly used for rapid, sensitive confirmation, particularly useful in culture-negative cases or where prior antibiotic use has reduced culture yield.
1 Enteric (Typhoid) Fever
Other Years Asked
1 A 20-year-old woman came to the Medicine OPD with history of fever, fatigue and
abdominal discomfort since 4 days. It did not resolve with antipyretics. Samples were
collected for the common probable causes of this condition and was confirmed as
typhoid fever.
( 2023 January (Supplementary) (2019 Scheme) Essay · 15 marks 2 A 5-year-old girl was brought in by her mother with the symptoms of fever, vomiting (7-8
episode 2022 February (2019 Scheme) Essay · 15 marks 3 A 70 year old man was brought to the emergency department with fever, cough, and dyspnoea. Physical
examination revealed a dull note on percussion. X-ray chest revealed a patch on the right lung area. The
gram stain of sputum sample revealed numerous pus cells and Gram positive lanceolate shaped
diplococci. 2024 December (Supplementary) (2019 Scheme) Essay · 10 marks 4 Read the clinical history and answer the following questions:
A 15 years old boy was admitted in ward with history of fever, malaise, anorexia and
adnominal discomfort. He had a coated tongue, toxemia, relative bradycardia and
splenomegaly on palpation of abdomen. 2013 September (Supplementary) (2010 Scheme) Essay · 10 marks 5 A thirty two years old lady presented with complaints of step ladder type of high fever,
headache and coated tongue for the past ten days. She had hepatosplenomegaly
and bradycardia. Blood count showed leucopoenia. Answer the following:
What is the diagnosis of this condition
Name the species of bacteria causing this condition
Discuss about the pathogenesis of this disease
How will you confirm the diagnosis in the laboratory
Name the vaccines used for prevention of this disease (1+1+3+3+2) 2018 July (Supplementary) (2010 Scheme) Essay · 10 marks 6 A young adult female presented with headache, fever and abdominal discomfort for
the past 5 days. On examination, she was toxic with a temperature of 1010 F, coated
tongue and mild splenomegaly were also present. 2025 August (Supplementary) (2010 Scheme) Essay · 10 marks 7 A 25 years old male comes to a medical outpatient department with complaints of high
fever with relative bradycardia for the past one week, he has headache, coated tongue
and hepatosplenomegaly. Answer the following: 2014 March (2010 Scheme) Essay · 10 marks 8 A 30 years old male patient suffering with intense headache, abdominal discomfort
since 6 days. He developed fever of remittent type with gradual rise in a step ladder
fashion. On examination he was toxic with temperature of 101.40F, tongue was
coated and mild splenomegaly present.
What is the most probable diagnosis. Name the causative agents.
Describe the pathogenesis of this disease
Describe in detail the sample collection and laboratory diagnosis of this
condition.
Name four drugs used for treatment
Discuss the preventive measures (2+2+3+1+2) 2022 May (Supplementary) (2010 Scheme) Essay · 10 marks 9 A male patient aged 20 years came with a history of fever for 15 days duration with
coated tongue and soft palpable spleen. Answer the following: 2016 October (Supplementary) (2010 Scheme) Essay · 10 marks 10 A 12-year-old child complained of high fever (1010C), malaise and abdominal pain since
7 days. A blood culture and the Rapid Typhi-dot test was found positive. 2024 March (Supplementary) (2019 Scheme) Essay · 6 marks 11 Agglutination type of reaction in antigen-antibody combination. 2013 April (2010 Scheme) Short Essay · 5 marks 12 Pathogenesis and laboratory diagnosis of enteric fever 2014 September (Supplementary) (2010 Scheme) Short Essay · 5 marks 13 Name four tube agglutination tests. Describe in detail any one of them. 2021 February (Supplementary) (2010 Scheme) Short Essay · 5 marks 14 Pathogenesis and lab diagnosis of typhoid fever. 2017 February (2010 Scheme) Short Essay · 5 marks 15 Agglutination. 2023 March (Supplementary) (2010 Scheme) Short Essay · 5 marks 16 Agglutination reactions 2015 February (2010 Scheme) Short Essay · 5 marks 17 Pathogenesis and laboratory diagnosis of enteric fever. 2016 February (2010 Scheme) Short Essay · 5 marks 18 Enumerate the agents causing enteric fever. Name the serological test indicated for the above condition.
In which week of illness should the test be done. What is the gold standard method for diagnosis and in
which week of illness is it highly sensitive. (1+1+1+0.5 +0.5) 2024 December (Supplementary) (2019 Scheme) Short Answer · 4 marks 19 Widal test 2022 October (Supplementary) (2010 Scheme) Short Note · 2 marks 20 Name FOUR antigen- antibody reactions 2025 March (Supplementary) (2010 Scheme) Short Note · 2 marks 21 Halophilic Vibrios 2025 March (Supplementary) (2010 Scheme) Short Note · 2 marks 22 Name any two antigen-antibody reactions. 2023 July (Supplementary) (2010 Scheme) Short Note · 2 marks 23 Listeria monocytogenes. 2013 September (Supplementary) (2010 Scheme) Short Note · 2 marks 24 Laboratory diagnosis of enteric fever 2021 May (Supplementary) (2010 Scheme) Short Note · 2 marks 25 Widal test 2017 August (Supplementary) (2010 Scheme) Short Note · 2 marks 26 Widal test. 2020 February (Supplementary) (2010 Scheme) Short Note · 2 marks 27 Name two complications of Enteric fever 2023 July (Supplementary) (2019 Scheme) 1 mark 28 Name the reservoir of infection and method of transmission of Penicillium marneffei
infection. 2022 February (2019 Scheme) 1 mark 
