Which techniques are used for bone marrow aspiration and blood culture in the diagnosis of typhoid fever (enteric fever)?

Updated: Aug 19, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Bone marrow aspiration and blood are cultured in a selective medium (eg, 10% aqueous oxgall) or a nutritious medium (eg, tryptic soy broth) and are incubated at 37°C for at least 7 days. Subcultures are made daily to one selective medium (eg, MacConkey agar) and one inhibitory medium (eg, Salmonella-Shigella agar). Identification of the organism with these conventional culture techniques usually takes 48-72 hours from acquisition.

Table 2. Sensitivities of Cultures [2, 38, 39, 40] (Open Table in a new window)

 

Incubation

Week 1

Week 2

Week 3

Week 4

Bone marrow aspirate (0.5-1 mL)

 

90% (may decrease after 5 d of antibiotics)

Blood (10-30 mL), stool, or duodenal aspirate culture

40%-80%

~20%

Variable (20%-60%)

Urine

 

25%-30%, timing unpredictable


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