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By Mayo Clinic staff
Medical and travel history
Your doctor is likely to suspect typhoid fever based on your symptoms and your medical and travel history. But the diagnosis is usually confirmed by identifying S. typhi in a culture of your blood or other body fluid or tissue.
Blood or body fluid or tissue culture
For the culture, a small sample of your blood, stool, urine or bone marrow is placed on a special medium that encourages the growth of bacteria. In 48 to 72 hours, the culture is checked under a microscope for the presence of typhoid bacteria. A bone marrow culture often is the most sensitive test for S. typhi.
Antibody and antigen testing
Your doctor may recommend other tests to help diagnose typhoid fever, such as:
- Enzyme-linked immunosorbent assay (ELISA). This blood test looks for an antigen that's specific to typhoid bacteria. An antigen is any substance, such as a virus, bacterium, toxin or foreign protein, that triggers an immune system response in your body. An ELISA test can identify if you carry the disease, but not whether you have an active infection.
- Fluorescent antibody test. This test checks for antibodies to S. typhi. Antibodies are proteins produced by your immune system in response to harmful substances (antigens). Each antibody is unique and defends your body against a single antigen.