title: Utility of polymerase chain reaction in diagnosis of tuberculosis from samples of bone marrow aspirate.
abstract: Fever of unknown origin (FUO) poses a diagnostic challenge to the clinicians, with a differential diagnosis as varied as neoplastic and infectious diseases. In developing countries, the infectious causes are responsible for more cases of FUO, with tuberculosis as one of the main causes of classic FUO. Disseminated tuberculosis with negative pulmonary findings is a diagnostic problem. This study examines the diagnostic utility of the polymerase chain reaction (PCR) in samples of bone marrow aspirate in 85 patients presenting with diverse clinical symptoms. Using primers specific for Mycobacterium tuberculosis, tubercular etiology was detected in 33% of patients clinically suspected of tuberculosis while culture on Lowenstein-Jensen medium grew M. tuberculosis in only one patient (2.5%). None of these patients had been diagnosed by microscopy. Clinical improvement with ATT was observed in 85% of the patients with positive PCR. PCR demonstrated much higher sensitivity and specificity, thereby facilitating early therapeutic decisions for suspected extrapulmonary tuberculosis.
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India. urvashi00@hotmail.com
authors.forename: Urvashi B
authors.initials: UB
authors.lastname: Singh
authors.forename: N Vijaya
authors.initials: NV
authors.lastname: Bhanu
authors.forename: V Naga
authors.initials: VN
authors.lastname: Suresh
authors.forename: Jyoti
authors.initials: J
authors.lastname: Arora
authors.forename: Tanu
authors.initials: T
authors.lastname: Rana
authors.forename: Pradeep
authors.initials: P
authors.lastname: Seth
mesh_terms: D001853:Bone Marrow / Q000382:microbiology* / Q000473:pathology; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000175:diagnosis*
chemical_list: D004269:DNA, Bacterial