Try it
PSM · Communicable diseases: blood culture in typhoid
Sample itemA 20-year-old with step-ladder fever for 5 days, relative bradycardia and abdominal discomfort is suspected to have enteric fever. Which investigation has the highest diagnostic yield at this stage?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Blood culture
Blood culture is positive in the majority of patients in the first week and remains the best single test early in the illness. Stool and urine cultures become more useful in the second and third weeks. A single Widal titre is unreliable in endemic areas because of baseline antibodies.
Option by option
A. Stool culture
Stool culture is positive more often from the second or third week.
B. Widal test on a single serum sample
A single Widal titre is unreliable in endemic regions because many people have background antibodies.
C. Urine culture
Urine culture is positive less often and only later in the illness.
D. Blood culture (correct)
Correct. Blood culture has the highest yield during the first week of illness.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
More PSM questions
- BiostatisticsOf 200 people who truly have a disease, a screening test is positive in 180. What is the…
- Environmental healthAfter one hour of contact time, what residual free chlorine level is generally recommend…
- EpidemiologyWhich study design is the most efficient for investigating risk factors of a rare disease?
- BiostatisticsIn hypothesis testing, a Type I error is: