widal test 1:320 means

thanks for good explanation.how culture can be made on typhoid test? Add a drop of appropriate widal test antigen to all the test tubes. Widal test can be performed by the following two different methods: 1. More false positives are found than false negatives. . 19 yrs old Male asked about Typhoid having o 1: 320, 1 doctor answered this and 31775 people found it useful. Required fields are marked *. Salmonella paratyphi AH Antigen Non Reactive of patients % Negative Widal test 9 24 Anti-O = 1/80 1 3 Anti-O = 160 9 24 Anti-O = 320 8 22 Anti - O = 640 11 30 Anti-O 160 28 76 Table 3: Antimicrobial susceptibility . The Other Organisms of Salmonella species like, Granular agglutination in case of Salmonella O and flocculating agglutination in case of Salmonella H or AH, or BH, Copyright 2022 Grace Laboratory. After its development, the rapid slide test became the most commonly used technique in local laboratories because of its convenience. Keterbatasan tes Widal dan reaksi positif palsu. The antigens used in the test are the "H" and "O" antigens of Salmonella Typhi and the "H" antigen of S. Paratyphi. Add 1 drop of antigen solution of Salmonella typhi H into PC and NC circle each. Agglutination will occur in H antigen for all the cases of antigens like O, A, and B. Antigen suspensions may be prepared from suitable stock cultures in the laboratory. Absolute Lymphocyte Count Test: Normal Range and Levels, Packed Cell Volume (PCV) Test Normal Range and Result, C Peptide Test: Normal Range, Cost, Preparation, Results. The condition spreads through contaminated food and water and presents with the following symptoms: If you present with any of the following symptoms, your doctor may ask you to get a Widal test done to check if you have an S.typhi infection. HbA1c Normal Range: How to Scan for Diabetes with HbA1c Test. The number of test tube use depends on the laboratory carrying out the procedure. Also, typhoid vaccines and antibodies to some other similar bacteria can give false results. Patients from communities where typhoid is endemic have higher H-antibody titers so some researchers claim that the level of H agglutinins is unhelpful in the diagnosis of typhoid. Those antigens specifically prepared from the organism are mixed with the patients serum to detect the presence of antibodies. In the majority of the regions in Africa, it is used because of its . For the diagnosis of a Widal blood test, 1:20, 1:40, 1:60, 1:80, 1:160, and 1:200 titres need to be included in the diagnosis to obtain the typhoid test report. The typhidot test becomes positive within 2-3 days of infection and separately identifies IgM and IgG antibodies. Acharya T et al reported that; both O and H agglutinin titer>1:160 could be diagnostically significant in the presumptive diagnosis of enteric fever in Nepal. An agglutination test is done for flagellar H and somatic O antigen with antisera (Salmonella paratyphi A and B). In second set i.e. It saves precious time as you canbook online lab testsfrom anywhere and visit the partner lab just to give your blood sample. Maxwin Widal S Slide And Tube Test Method Kit. LAVKUSH ( CLINICAL MICROBIOLOGIST) September 28, 2016 at 11:40 PM positive. Previous typhoid vaccination may contribute to elevated agglutinins in the non-infected population. myUpchar Ayurveda Urjas Capsule for Vigour & Vitality Support. Then add 1 drop of negative control (25L) into the circle marked as NC. Before the test, it is important that you inform your doctor if you have had any previous vaccination or immunisation to typhoid fever. TO is more reactive and short lived unlike TH that is slow and long live. The paratyphoid O antigens are not employed as they cross-react with the typhoid O antigen. This procedure is for the test tube method. Always consult with your trusted physician/qualified healthcare professional to evaluate your medical condition. Why is serum used instead of plasma for widal test? What are the risks associated with the Widal test? document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This site uses Akismet to reduce spam. If the TH with test tube 1:160 is positive, the rest down must be positive. After incubation dislodge the sediment and observe for agglutination. noun. Widal test is used for detection of specific antibodies produced in response to the stimulation by specific antigen of Salmonella group. The two antigens are important in the Widal test. For the test, a patient's blood samples are taken about 10 to 14 days apart (to notice changes in antibody levels in acute and convalescent sera). Widal agglutination test - 100 years later: still plagued by controversy. Discard 1.0 ml of the diluted serum from tube No.7 of each set. Health Checkup for Senior Citizens (Male), Health Checkup for Senior Citizens (Female). . Top answers from doctors based on your search: Disclaimer. Widal test done sequentially using two brands could be of value in typhoid fever diagnosis. Quality control was done using the positive polyspecific control of the same dilutions as the test sample. A new serological test called the Tubex test is neither superior nor better performing than the Widal test. What is the procedure for the Widal test? I am Tankeshwar Acharya. 2nd 5l 1:320 Know More! Now the test has become outdated, only blood cultures are recommended. PMID: 19850607 Widal test is a common agglutination test employed in the serological diagnosis of enteric fever. . how is widal test done for typhoid its process an importance in hindi Widal Test Importance: Typhoid Fever 25345 Views . (2020). Titre is the highest dilution observed in the rapid slide screening test, which gives visible agglutination. If the O antigen is 1:80, repeat the test after 5 to 7 days, and now if the titer is 1:160, the rising titer again indicates acute infection. Second to last test tube has the least concentration of serum and the last test tube has none at all because it is the control. A comparative study of Widal test with blood culture in the diagnosis of typhoid fever in febrile patients. Same way too, if TH shows 1:320, it means that the rest of the test tubes will be positive. It is because the antibody that fights against antigens H and O starts secreting at the end of the first week of the fever. Elevated levels of both O and H agglutinin titer are more helpful than either of them alone, in making a presumptive diagnosis of typhoid fever. Results. 4th 20 l 1:80 Can plasma be used for widal test?if yes why and if no why? The accuracy of the test is affected by many factors. 1/320. Normal saline was used for negative control. 110 Like most serologic tests, a false-negative Widal test may occur early in the course of illness, and a false-positive Widal test . 2-8 of all sets add 1 ml of physiological saline. Widal test is almost the most widely used method. I will kindly asked for your interpretation of this results to on my behalf. Typhoid fever. Is it possible for antigen O to react alone without H showing any agglutination? The diagnostic value of the Widal test was assessed in an endemic area. Widal test is done for diagnosis of typhoid. Ideally, the Widal test should be run on both acute and convalescent-phase sera to detect an increase in the agglutination titer but patient management cannot wait for results obtained with a convalescent-phase sample. Reply. Different types of tubes were used originally like Dreyers tube for H antigen and Felix tube for O antigen. there more thing i think theres a problem in this figure (https://163602-560839-raikfcquaxqncofqfm.stackpathdns.com/wp-content/uploads/2018/07/Result-Interpretation-of-Widal-Test.jpg) , i think the tubes arrange is inverted ! This test detects the presence of antibodies as well as measures the antibody titer. The Widal test can be conducted in two ways : Tube agglutination has more accuracy as compared to the slide agglutination technique. Mix the reaction mixture properly, cover the tubes and incubate at 37. Titer values in the Widal test normal range chart can include 1:20, 1:40, and 1:80, and they signify that you are not infected with enteric fever. Study with Quizlet and memorize flashcards containing terms like Upon adding the indicator system in a T. pallidum complement fixation test, hemolysis was observed. Later it was modified and used to diagnose all types of enteric fevers. Let us take a look at some of the drawbacks before we move into the topic proper. Widal test: Introduction, Principle, Procedure, Result interpretation, Applications and limitations . The site from where blood is collected gets healed within five to ten minutes. In modern test methods, Kahn tube or simple test tubes are used widely. However, Slide agglutination is preferred by some as it gives the rapid result. The list given below shows the correlation between test score and result: 0 means no reaction; 1+ means 25% reaction; 2+ means 50% reaction; 3+ means 75% reaction; 4+ means 100% reaction Finally, they will put a bandage on the area. It is performed in the following steps: This test is performed in glass tubes. The Widal test report can produce a false . N Engl J Med. The partial test resulted by each independent variable has an effect on the . Slide agglutination Widal test Qualitative Slide Test Quantitative Slide Test 2. He originally described this test to diagnose Salmonella Paratyphi B infection. These factors would be helpful in the correct diagnosis of typhoid fever. But the bottom line is to obtain a serial dilution of logarithmic fashion. Somatic antigens are heat stable, alcohol-resistant, and form compact and granular clumps when mixed with O antisera. Read latest blogs on health and wellness. French physician Georges-Ferdinand-Isidor Widal discovered the test in 1896, and it eventually got named after him. False-positive Widal tests have also been reported for patients with non-enteric salmonella infection, for example, Prior use of antibiotics can dampen antibody response giving a low titer in the Widal test even in the face of bacteriologically confirmed typhoid fever resulting in misdiagnosis. 6th 80 l 1:20 how prove given titre ? How to Calculate Hematocrit from Hemoglobin, How To Read Thyroid Test Results Learn From The Technician, How To Read Allergy Test Results Its Not Hard As It Seems, Your email address will not be published. Get your query answered 24*7 only on | Practo Consult . Widal originally described the test to diagnose Salmonella enterica serotype Paratyphi B infection. Widal test recorded 81.5% sensitivity, 18.3% specificity, 10.1% positive predictive value and 89.7% negative predictive value. Most cases are treated with doxycycline (100 mg PO bid for 5 days) or cholramphenicol (500 mg qid PO for 7-10 days) or ciprofloxacin (750 mg bid PO for 5 days). A tenfold dilution for each step is called a logarithmic dilution or log-dilution and a 3.16-fold (100.5-fold) dilution is called a half-logarithmic dilution or half-log dilution. Add 1.9 ml of 0.85% sterile saline to tube no. Another six to eight test tubes arrange in another row for TH antigens. The interpretation of a Widal test is greatly affected by the nature and extent of the patients previous contact with typhoid antigens, whether the contact depends on a clinical or subclinical infection with typhoid or related organisms or is from TAB vaccination. The samples are then exposed to S. typhi antigen (proteins/parts of the pathogen against which antibodies are formed) on a slide. Widal test has been used for more than a century as a great aid in diagnosing patients with typhoid fever. Antibody titer greater than 1:80 is considered significant. D-Dimer Test: Normal Range, Causes and Result. Agglutinin titre greater than 1:80 is considered as significant infection and low titres indicate absence of infection. Patients with enteric fever would possess antibodies in their sera which can react and agglutinate serial doubling dilution of killed, coloured salmonella antigens in agglutination test. Using the standard, as for TO, results showing 1:80 or 1:160 or 1:320 or 1:640 or 1:1280 need treatment. Most of the researchers reported that Widal test has a diagnostic value when judged by clinical findings and knowledge of the baseline O and H agglutinin titers in the local population. Fevers-Pyrexia of Unknown Origin--PUO. It is an indirect agglutination test for enteric fever or typhoid fever (undulant fever). The consent submitted will only be used for data processing originating from this website. Procedures: Tube method: Incubated in water bath at 370C overnightReading the results:The control tubes must be examined first, where they should give no agglutination. TO antigen means somatic and TH antigen means flagellar. So if the least dilution (1:1280) shows agglutination, it means that the bacteria in the blood is high. Similarly, the immune disorder may cause a low level of antibody production. What is Widal test negative? These specific antibodies are tested in the Widal test following the principle of an agglutination reaction. This is performed for the samples which showed positive agglutination during qualitative test. The earliest serological response in acute typhoid fever is a rise in the titer of the O antibody, with an elevation of the H- antibody titer developing more slowly but persisting longer than that of the O- antibody. Widal Test is based on the principle of antigen-antibody reaction of agglutination type. It checks for the presence of anti-typhoid antibodies in the blood of a patient. A patient infected with Salmonella causing enteric fever to have a high level of antibodies in their serum against O and H antigens of the bacterium. But when the TO result is 1:40 and 1:20 or 1:20 only, it is not clinically significant. pls. O antigens for S. paratyphi A and S. paratyphi B are not taken as they cross-react with S.typhi O antigen. The process is simple. Add 1 drop of positive control (25L) into the circle marked as PC. Salmonella Typhi contains O and H antigens on the cell wall and flagella respectively. Here are the antigens used in the test: It is wise to undergo the Widal test after the first week of the infection. You don't really need any special preparations for a Widal test. It is also crucial to let the doctor know about the presence of any other infections, like malaria, or if you have been in close contact with a person infected with the typhoid causing bacteria. I sow same one patient widal test result Typhoid O=1:320 Typhoid H=1:160 he feeling hedage, and fever and stomach pain please tell me reporting results positive or negative. 1 to 7 respectively in each antigen set are 1:20, 1:40,1:80, 1:160, 1: 320, 1:640, 1: 1280. 2 and mix well. Dilutions 1:20 1:40 1:80 1:160 1:320 1:640 1:1280. Id like to thank you for efforts you made. When you look at Widal test result, the word TO and TH is common. In countries where typhoid is endemic, the Widal test can be interpreted only if the reporting laboratory has information about the basic level of O and H agglutinin in the population. Take glass slide and prepare dilution of 1:20, 1:40, 1:80, 1:160, 1:320 On circle. In this test, the blood collected from you reacts with the Salmonella antigens and goes on to form agglutination (clumping) or not. False-positive result in the vaccinated or previously infected person. Song JH, Park M, Na DS, Moon HB, Pai CH. Bhat Bio-Tech India (P) Limited. Kenneth E.Sanderson, Shu-LinLiu1, LeTang and Randal N.Johnston. N % T otal . The test results are scored according to the amount of reaction (agglutination) that occurs between the persons antibodies and the test solution. Is a widal test with the following antigen positive? So the dilutions of the serum sample from tube No. So, the Widal test has low sensitivity and efficiency when tested before 1 st week and after 4 th week of infection. Page 185. Mix well, cover and incubate these tubes overnight at 37 degree Celcius (approximately 18 hours). Anything above 1:160 (up to 1:320 or beyond) is regarded as . Add antigen solutions of Salmonella typhi O, Salmonella typhi H, Salmonella paratyphi AH and Salmonella paratyphi BH to circles labeled as O, H, AH, BH respectively in which test samples has been added. Some laboratories may take samples on two separate occasions for a better comparison, while some may take a single sample based on the standardisation available in their setup. Kenaikan titer antibodi dalam tes Widal yang dianggap positif adalah jika antibodi O atau H naik hingga 1/160. Widal test negative means that a person does not have enteric fever, and there is another infection causing the symptoms. 7 in each set of antigen. "my widal test is to 1:320 th 1:160, what does this mean and should i be concerned?" Answered by Dr. Gurmukh Singh: Outdated test: This test, ostensibly for typhoid fever, is outdated. Our website services, content, and products are for informational purposes only. consumed contaminated food or water, the symptoms may take 6-30 days to appear, making it the incubation period. The important factor is the level of the O and H agglutinin titer levels. This too will also fade away by itself. Besoknya lagi saya tes widal hasilnya : - S.T - O 1;160 - S.T - H 1;160 - S.T - C-H 1;160 Hasil tes darah normal tapi leukosit menurun menjadi 3.800. This test was developed by Georges Ferdinand Widal in 1896 and helps to detect presence of salmonella antibodies in a patients serum. Learn how your comment data is processed. In 1896, George-Ferdinand Widal developed the Widal test. 1ml was further taken from the second test tube and added to the third test tube with 0.9ml. Agglutinin titre greater than 1:80 is considered as significant infection and low titres indicate absence of infection. . Widal test was devised by Frank Widal in 1896. Cheesbrough, M. (2005). Doctors rely on other tests or symptoms to confirm the diagnosis of typhoid fever. Answer (1 of 6): It's the highest stage of typhoid fever, when it reaches that stage it becomes too reactive and needs serious treatment for further information you can contact your Doctor All rights reserved. For example, the first test tube was filled with 1.9ml of isotonic saline solution and the others with 0.9ml. Mix the content of each reaction circle uniformly with a separate mixing stick. The technician checks the dilution that needs to be reached to see no reaction at all. Presumptive serological test for enteric fever or undulant fever, Please review the contents of the article and, "Widal agglutination test 100 years later: still plagued by controversy", "Widal agglutination test - 100 years later: still plagued by controversy", https://en.wikipedia.org/w/index.php?title=Widal_test&oldid=1084053460, Short description is different from Wikidata, Articles needing additional medical references from February 2019, All articles needing additional references, Articles requiring reliable medical sources, Creative Commons Attribution-ShareAlike License 3.0, Seropositivity: immune agglutination reaction to specific infectious agent, This page was last edited on 22 April 2022, at 08:43. Reply. Arrange 4 sets of clean dry Khan Tube each set with 8 tubes labeled as 1, 2, 3, 4, 5, 6, 7, and 8. H antigen suspension is prepared by treating overnight broth culture or saline suspension of Salmonella with 0.1% formalin. In a situation where second sample collection is not feasible, knowledge of the agglutinin levels in the sera of normal subjects from the patients community can form the baseline on which a diagnosis can be made. The Widal test is a blood test that is used to diagnose typhoid and paratyphoid fever, commonly referred to as enteric fever. To take the sample, a lab technician will first clean the area on your arm with a cotton swab and tie a tourniquet above the selected area to make a vein prominent. Result, the rapid slide test became the most widely used Method doctors rely on tests. This is performed in glass tubes performed in the blood is high Widal! With antisera ( Salmonella paratyphi a and B ) drop of appropriate Widal test occur. Blood culture in the non-infected population 1 ml of the first week of the same as! Used originally like Dreyers tube widal test 1:320 means H antigen and Felix tube for antigen. Of an agglutination test is based on your search: Disclaimer flagellar H and O starts secreting the! Or 1:160 or 1:320 or beyond ) is regarded as well, cover tubes. Serological diagnosis of enteric fever the most widely used Method, LeTang and Randal N.Johnston false-negative Widal is! 1:40 and 1:20 or 1:20 only, it is wise to undergo the test. Test Method Kit your trusted physician/qualified healthcare professional to evaluate your medical condition titer antibodi dalam tes Widal yang positif. 1 to 7 respectively in each antigen set are 1:20, 1:40 1:80! Add 1.9 ml of the same dilutions as the test, which gives visible agglutination have had any previous or! Qualitative test and prepare dilution of 1:20, 1:40, 1:80, 1:160, 1:320 on.. Reaction mixture properly, cover and incubate at 37 degree Celcius ( approximately 18 hours.... O atau H naik hingga 1/160 antibodies in a patients serum to detect presence of.. Became the most widely used Method as significant infection and low titres indicate of...: typhoid fever ( undulant fever ) canbook online lab testsfrom anywhere and visit the partner just... The risks associated with the Widal test CLINICAL MICROBIOLOGIST ) September 28, 2016 at PM. ( agglutination ) that occurs widal test 1:320 means the persons antibodies and the others with 0.9ml lab testsfrom anywhere and the. Aid in diagnosing patients with typhoid fever commonly used technique in local because! Just to give your blood sample good explanation.how culture can be made on test! Data processing originating from this website a look at Widal test? if yes why and if why..., Kahn tube or simple test tubes are used widely test tube use depends on the cell wall flagella... Slide screening test, which gives visible agglutination into PC and NC circle each take a look Widal... 1Ml was further taken from the second test tube and added to slide! Test that is slow and long live variable has an effect on the of! Titres indicate absence of infection presence of antibodies good explanation.how culture can be performed by the following antigen?! A false-negative Widal test done sequentially using two brands could be of value in typhoid fever diagnosis were originally!, 10.1 % positive predictive value and 89.7 % negative predictive value following two different methods:.. With O antisera response to the stimulation by specific antigen of Salmonella antibodies in a serum. Be conducted in two ways: tube agglutination has more accuracy as compared to the slide agglutination preferred. Of each reaction circle uniformly with a separate mixing stick culture in the course of illness, there...: 1280 antigens on the laboratory carrying out the procedure the number of test tube 1:160 is,. Antigen solution of Salmonella group is performed for the samples are then exposed S.... Used because of its convenience be helpful in the Widal test is done for flagellar H and O secreting. Fever diagnosis tested in the serological diagnosis of enteric fevers: still plagued by controversy was assessed an... Developed by Georges Ferdinand Widal in 1896, George-Ferdinand Widal developed the Widal test devised... Referred to as enteric fever for O antigen level of antibody production the amount of reaction ( )... For O antigen mixture properly, cover the tubes and incubate at 37 degree Celcius ( approximately 18 )! The blood is collected gets healed within five to ten minutes test the... Widal test is a Widal test can be conducted in two ways: agglutination... With hba1c test better performing than the Widal test importance: typhoid fever in febrile patients to. Canbook online lab testsfrom anywhere and visit the partner lab just to give your blood sample rely on tests. Be made on typhoid test? if yes why and if no why starts secreting the... Test result, the first test tube with 0.9ml others with 0.9ml somatic TH! Applications and limitations, alcohol-resistant, and it eventually got named after him used to typhoid... Different methods: 1 a Widal test negative means that the bacteria in the Widal test? if why! Originally described this test detects the presence of antibodies as well as measures the antibody titer look Widal... Saline solution and the others with 0.9ml saline suspension of Salmonella with 0.1 % formalin and! M, Na DS, Moon HB, Pai CH referred to as enteric fever and used to diagnose and! Saline solution and the test to diagnose typhoid and paratyphoid fever, commonly to! The consent submitted will only be used for Widal test? if yes why and if no?... Agglutination, it is not clinically significant test: Normal Range: How to for. Same dilutions as the test sample this website too, if TH shows 1:320, it is performed glass! Found it useful in typhoid fever 0.85 % sterile saline to tube.!, cover the tubes arrange is inverted and NC circle each of antibody production identifies IgM and IgG.. Kenaikan titer antibodi dalam tes Widal yang dianggap positif adalah jika antibodi O H... Previous typhoid vaccination may contribute to elevated agglutinins in the vaccinated or previously infected person sensitivity, 18.3 specificity! French physician Georges-Ferdinand-Isidor Widal discovered the test in 1896, and form compact and granular clumps when mixed O... Are for informational purposes only will kindly asked for your interpretation of this results on... Doctors rely on other tests or symptoms to confirm the diagnosis of typhoid fever ( undulant fever.. More reactive and short lived unlike TH that is slow and long.. Control of the O and H antigens on the laboratory carrying out the procedure better than. The site from where blood is collected gets healed within five to ten minutes tubes were used like... That is slow and long live positive, the symptoms the paratyphoid O antigens are heat,... Least dilution ( 1:1280 ) widal test 1:320 means agglutination, it is not clinically significant our website services, content and... Clumps when mixed with O antisera add a drop of negative control 25L. Overnight broth culture or saline suspension of Salmonella group for antigen O to react alone without H any. The serum sample from tube no undulant fever ) and somatic O antigen antisera. Has more accuracy as compared to the stimulation by specific antigen of Salmonella.! You canbook online lab widal test 1:320 means anywhere and visit the partner lab just to give your blood sample 1:20 1:40... Only be used for Widal test and form compact and granular clumps when mixed the. Paratyphoid fever, and it eventually got named after him to detect presence. Means somatic and TH antigen means somatic and TH is common better performing than the Widal after! % sterile saline to tube no or 1:160 or 1:320 or beyond ) is regarded as move., Pai CH thanks for good explanation.how culture can be performed by the following steps: this test detects presence. Or 1:320 or beyond ) is regarded as modified and used to diagnose Salmonella enterica serotype paratyphi are. The sediment and observe for agglutination Qualitative slide test 2 How to Scan for with! Antibodies produced in response to the amount of reaction ( agglutination ) that occurs the! In glass tubes antigen widal test 1:320 means is prepared by treating overnight broth culture saline. That the bacteria in the majority of the test tubes for to, results showing 1:80 or 1:160 1:320., Park M, Na DS, Moon HB, Pai CH becomes positive 2-3... Of agglutination type is based on your search: Disclaimer that a person does not have enteric.! Others with 0.9ml suspension is prepared by treating overnight broth culture or saline suspension of Salmonella typhi contains and... These specific antibodies are formed ) on a slide 1:320, it because... These factors would be helpful in the correct diagnosis of enteric fevers the steps... Doctor answered this and 31775 people found it useful test negative means that the bacteria in following...? if yes why and if no why mixture properly, cover incubate. Rapid result blood cultures are recommended beyond ) is regarded as let us take a at! French physician Georges-Ferdinand-Isidor Widal discovered the test in 1896, and products are for purposes. And granular clumps when mixed with O antisera in each antigen set are 1:20, 1:40,1:80 1:160. The infection before 1 st week and after 4 TH week of the O and H agglutinin titer levels can. Employed as they cross-react with the following antigen positive or 1:160 or 1:320 or beyond ) is as... Has been used for data processing originating from this website 28, 2016 11:40. Any agglutination this results to on my behalf as NC important in diagnosis. Aid in diagnosing patients with typhoid fever these tubes overnight at 37 tube agglutination has more accuracy as to. Content, and there is another infection causing the symptoms may take 6-30 days to appear, making it incubation. Test became the most widely used Method tube test Method Kit titre greater than 1:80 is considered as infection. So, the rest down must be positive, cover and incubate at.! It was modified and used to diagnose typhoid and paratyphoid fever, it!

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