Paediatric infections: bone marrow culture in typhoid: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Paediatric infections: bone marrow culture in typhoid

Sample item

A 6-year-old with 10 days of fever suspected to be enteric fever has already received 3 days of oral antibiotics, and the blood culture is sterile. Which test is most likely to still isolate the organism?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Bone marrow culture

Salmonella persists in the reticuloendothelial system, so bone marrow culture is the most sensitive test and stays positive even after antibiotic therapy. Blood culture yield falls with duration of illness and prior antibiotics. Widal has poor specificity in endemic areas.

Option by option

  • A. Stool culture in the first week

    Stool culture is positive mainly after the first week and is not as sensitive.

  • B. Widal test on a single sample

    A single Widal titre is unreliable in endemic regions and cannot confirm infection.

  • C. Urine culture

    Urine culture has low yield and is positive only in later weeks.

  • D. Bone marrow culture (correct)

    Correct. Bone marrow culture has the highest sensitivity and is least affected by prior antibiotics.

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.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Bone marrow culture. Salmonella persists in the reticuloendothelial system, so bone marrow culture is the most sensitive test and stays positive even after antibiotic therapy.

Why is "Stool culture in the first week" not the answer?

Stool culture is positive mainly after the first week and is not as sensitive.

Why is "Widal test on a single sample" not the answer?

A single Widal titre is unreliable in endemic regions and cannot confirm infection.

Why is "Urine culture" not the answer?

Urine culture has low yield and is positive only in later weeks.

What concept does this question test?

It tests Paediatric infections: bone marrow culture in typhoid in Pediatrics. Blood culture yield falls with duration of illness and prior antibiotics. Widal has poor specificity in endemic areas.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric infections: bone marrow culture in typhoid?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.