Diagnostic yield of bone marrow examination in HIV associated FUO in ART naïve patients.
A bone marrow (BM) aspiration and biopsy is often believed to be a much needed diagnostic procedure in the work up of patients with fever of unknown origin (FUO), especially in the setting of AIDS. Is it worthwhile to proceed with this invasive diagnostic method? The usefulness of a BM aspiration or biopsy to assist in the diagnosis of FUO or prolonged fever in AIDS patients has been reported previously to range from 4% to 40%. The purpose of this study was to assess the usefulness of a BM aspiration and biopsy in diagnosing the cause of FUO in patients with AIDS and to identify the utility of the procedure for the diagnosis of malignancies/other hematological disorders resulting in the FUO. In this study, comprising of 30 patients, we have tried to find the diagnostic yield of bone marrow examination in finding the etiology of "FUO associated with HIV infection". Though similar studies have been reported in the literature but it is lacking from eastern India. The majority of BM examination in this series revealed infections followed by hematological disorders. Our study showed the diagnostic yield of bone marrow examination in "HIV associated FUO" to be 26.7%. It was found to be positive in 33.3% of the patients, who had the final diagnosis of an infective etiology and 100% of the patients, who had a final diagnosis of an underlying hematological etiology.
Pande
Arindam
A
Department of General Medicine, Medical College & Hospital, Kolkata, West Bengal, India. drapande@gmail.com
Bhattacharyya
Maitreyee
M
Pain
Shantasil
S
Ghosh
Anirban
A
Samanta
Ajanta
A
D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000175:diagnosis; D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage; D001706:Biopsy; D001853:Bone Marrow / Q000382:microbiology* / Q000473:pathology*; D001856:Bone Marrow Examination; D003430:Cross-Sectional Studies; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology*; D015658:HIV Infections / Q000150:complications*; D006658:Histoplasma / Q000302:isolation & purification; D006660:Histoplasmosis / Q000150:complications / Q000175:diagnosis; D006689:Hodgkin Disease / Q000175:diagnosis; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis; D055815:Young Adult
D044966:Anti-Retroviral Agents