Refractile mycobacteria in Romanowsky-stained bone marrow smears. A comparison of acid-fast-stained tissue sections and Romanowsky-stained smears.
The appearance of mycobacteria was studied in Wright-stained bone marrow preparations of human immunodeficiency virus-infected patients and compared with acid-fast-stained trephine biopsy sections and culture results. Mycobacterium avium complex in Romanowsky-stained preparations may be seen as extracellular and intracellular clear or red refractile beaded rods and nonrefractile "negative images." Refractile mycobacteria were seen in 17 of 20 culture-positive cases. Acid-fast stain of the trephine biopsy demonstrated organisms in only 11 of the 20 cases. Thus, six cases were culture positive and contained refractile rods but had no acid-fast organisms on the trephine biopsy. No false-positive results were seen with Romanowsky stain; the three false-negative results for refractility also were negative with acid-fast stain. Examination of Romanowsky-stained smears or imprints for refractile mycobacteria provides a reliable and sensitive method to identify mycobacteria in this population. Romanowsky-stained bone marrow aspirate and imprint smears should be examined for refractile bacilli when mycobacterial infection is suspected.
Department of Pathology, St. Luke's/Roosevelt Hospital, New York, New York 10019.
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Torlakovic
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Clayton
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Ames
D000163:Acquired Immunodeficiency Syndrome / Q000382:microbiology; D001399:Azure Stains; D001706:Biopsy; D001853:Bone Marrow / Q000382:microbiology* / Q000473:pathology; D004396:Coloring Agents; D004801:Eosine Yellowish-(YS); D005295:Ferrocyanides; D006801:Humans; D009161:Mycobacterium / Q000302:isolation & purification*; D013194:Staining and Labeling
D001399:Azure Stains; D004396:Coloring Agents; D005295:Ferrocyanides; C046541:Romanowsky-Giemsa stain; D004801:Eosine Yellowish-(YS); C000170:ferric ferrocyanide