Utility of bone marrow culture and biopsy in the diagnosis of disseminated infections in AIDS.
Bone marrow examination (BME) has been used as a diagnostic test of last resort in HIV infected patients. Identifying factors that would increase the diagnostic yield of BME would be useful. A retrospective cohort study was done to determine the predictive value of BME for disseminated infection in 133 patients with HIV infection in a 4-year period at an active HIV clinical center. Thirty-two percent of the cases had evidence of a disseminated infection on BME but only 10% of cases had a diagnosis made exclusively by BME. Multivariate analysis demonstrated that a positive result was more likely in those patients with fewer than 50 CD4 cells/mm3 and those with a hematocrit of less than 25% (P<0.01). BME can be a useful, low-risk diagnostic procedure in selected patients with HIV infection who are ill with a low CD4 count and/or have a hematocrit less than 25%. A diagnosis can usually be made by other means, suggesting that this test should be limited to those in whom other diagnostic modalities have been exhausted.
Keiser
P
P
Division of Infectious Diseases, University of Texas, Southwestern Medical Center, Dallas, USA.
Rademacher
S
S
Smith
J W
JW
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis*; D001424:Bacterial Infections / Q000175:diagnosis*; D001706:Biopsy; D001853:Bone Marrow / Q000382:microbiology* / Q000473:pathology; D002478:Cells, Cultured; D006801:Humans; D011237:Predictive Value of Tests