Typhoid in Pakistan: symptoms, tests (Typhidot, Widal, blood culture) and XDR typhoid
Typhoid symptoms, which test is reliable (blood culture vs Typhidot vs Widal), why XDR typhoid makes self-medication dangerous, and how to prevent it in Pakistan.
3 min readUpdated 31 October 2026
This is general information only, not medical advice. Please always confirm with your medical consultant or a certified doctor before using any medicine, test or treatment.
Typhoid (mohri bukhar) is a bacterial infection caused by Salmonella Typhi. It spreads through contaminated water and food, and it is common in Pakistan, especially in summer and the monsoon. Since 2016, a strain called XDR (extensively drug-resistant) typhoid has spread from Sindh to other parts of the country, and it does not respond to many common antibiotics.
Symptoms
Typhoid usually starts slowly, over several days:
- Fever that rises step by step, often highest in the evening.
- Headache, weakness and body aches.
- Stomach pain, loss of appetite, constipation or diarrhoea.
- Sometimes a dry cough or a few faint pink spots on the chest or stomach.
Without proper treatment, typhoid can cause serious complications such as bleeding or a hole in the intestine, usually in the second or third week.
Which test is reliable?
| Test | What to know |
|---|---|
| Blood culture | The most reliable test. Best done early, ideally before any antibiotic. It also shows which antibiotics will work, which is vital with XDR typhoid. Results take 2 to 5 days. |
| Typhidot | A quick antibody test. Useful as a guide but can be falsely positive or negative. |
| Widal | An old test that is often misleading in Pakistan, because many people have antibodies from past infections or vaccines. A positive Widal alone should not decide treatment. |
A CBC is often done too; it may show low or normal white cells. Read what a CBC shows.
Why you should not self-medicate
Taking a few days of an antibiotic from a medical store "just in case" is common, and it is one of the reasons resistance has grown.
- XDR typhoid does not respond to older antibiotics and many common injections. The right antibiotic depends on local resistance and the culture report, so a doctor must choose it.
- Starting an antibiotic before a blood culture can make the culture negative and hide the cause.
- Stopping early when the fever drops lets the infection come back. Finish the full course your doctor prescribes.
Medicines such as azithromycin, cefixime, ceftriaxone or meropenem may be used depending on the case. These pages list brands and prices, not doses: only a doctor should prescribe them.
Care at home
- Drink plenty of safe fluids and ORS; eat soft, fresh food.
- Use paracetamol for fever, in the correct dose (dose guide).
- See a doctor again if fever does not improve after a few days of treatment.
Warning signs: go to hospital
Severe stomach pain, vomiting blood or black stools, confusion, very high fever that does not come down, or a patient who is getting weaker. Call 1122 or find a hospital on the emergency page.
Prevention
- Typhoid conjugate vaccine (TCV): offered in Pakistan's routine immunisation for children and widely available for adults. Ask your doctor.
- Drink boiled or properly filtered water; avoid ice and drinks from unknown sources.
- Wash hands with soap after using the toilet and before eating.
- Avoid raw salads and cut fruit from street stalls, especially in summer.
This is general information only, not medical advice. Please always confirm with your medical consultant or a certified doctor before using any medicine, test or treatment.