Bone marrow biopsy in the diagnoses of infectious and non-infectious causes in patients with advanced HIV infection.
OBJECTIVE
Fever and peripheral blood abnormalities in patients with advanced acquired immunodeficiency syndrome are usually due to disseminated opportunistic infections. The objective of this study was to evaluate the diagnostic yield of histopathological and microbiological investigations of bone marrow samples from HIV-infected patients with fever and/or cytopenias.


RESULTS
The diagnostic utility of bone marrow aspiration, biopsy and culture was retrospectively examined in 82 patients with HIV/AIDS (median CD4 count 51 microL(-1), range 1-430 microL(-1)) with peripheral cytopenias and/or fever attended at a large tertiary care hospital in Brazil during a one-year period. The diagnostic yield of bone marrow biopsy was 34.1% (28 cases) in contrast to only 8.5% (eight cases) attained by the bone marrow smear. Opportunistic pathogens were isolated from bone marrow cultures in 26.8% of patients.


CONCLUSIONS
Bone marrow biopsy has value in diagnosis of opportunistic infections, malignancies or other conditions in one-third of adult patients with advanced AIDS and fever or cytopenias and should be considered in this patient group.
Tanaka
Paula Yurie
PY
Instituto de Infectologia Emílio Ribas, São Paulo, Brazil. pyt@uol.com.br <pyt@uol.com.br>
Hadad
David Jamil
DJ
Barletti
Silvia Cristina
SC
de Souza
Simone Aparecida
SA
Calore
Edenilson Eduardo
EE
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000382:microbiology; D000328:Adult; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000473:pathology*; D003470:Culture Media; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged
D003470:Culture Media