Publication:

Haematological profile in typhoid fever: an update from a tertiary rural hospital

Introduction Understanding hematological alterations in typhoid fever aids in diagnosis, assessment of disease severity and to monitor treatment response. To assess alterations in hematological parameters in patients with confirmed typhoid fever.

Methods A cross-sectional, retrospective study was conducted (1 May 2024-30 April 2025). All patients who had fever and tested for Typhoid and dengue were included in screening. Only confirmed typhoid positive on WIDAL with significant titres of 1:160 and 1:320 were included If patient had any dengue parameters positive, it was noted. Patients with only dengue were excluded.

Results Among 295 patients screened, 251 were diagnosed with typhoid fever. 24 patients (adults–22 children-2) were only typhoid positive and 227 patients (adults-204, children-23) had both typhoid and Dengue positive.  In patients with only typhoid TLC (total leucocyte count) was high up to 17000cell/mm3. TLC of patients with 1:160 and 1:320 titres were compared using Student t-test. ‘t’ value was significant indicating titres played a significant role in clinical management (p value <0.05). In patients with Typhoid and dengue positive, mild to moderate anemia and moderate to severe thrombocytopenia were observed, which was not observed in typhoid only patients.

Conclusion This study highlights relationship of TLC and titres in clinical management. Dengue fever and typhoid fever may overlap especially in endemic areas and may have effect on hemoglobin and platelet count. Widal positivity with observations in these alterations will serve as supportive indicators for diagnosis and management where blood culture is not available.