Hakawi A M, Alrajhi A A
Section of Infectious Diseases, Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
Int J Tuberc Lung Dis. 2006 Sep;10(9):1041-4.
To study the clinical and pathological patterns of tuberculosis (TB) involving the bone marrow in a tertiary care setting.
A retrospective study of cases of bone marrow TB diagnosed and treated at King Faisal Specialist Hospital and Research Center from 1990 to 2002. The main criterion for inclusion was the isolation of Mycobacterium tuberculosis from a bone marrow specimen.
We identified 22 patients with culture-proven M. tuberculosis infection of the bone marrow. Underlying conditions found in this series include solid organ transplantation in 4 patients (18%), HIV infection in 2 (9%), and diabetes in 3 (14%). No risk factor was identified in 12 patients (55%). Histopathological findings were reported as granuloma in 19 patients (86%) and caseating granuloma in 3 (14%). The outcome was favourable for 11 patients (50%), while 10 (45%) died during hospitalisation and one was lost to follow-up. For patients who completed their regimens, the duration of treatment was 12 months.
The isolation of M. tuberculosis from a bone marrow specimen is an indication of disseminated disease which carries a high mortality rate and requires prompt initiation of appropriate treatment.
在三级医疗环境中研究累及骨髓的结核病（TB）的临床和病理模式。
对1990年至2002年在费萨尔国王专科医院及研究中心诊断和治疗的骨髓结核病例进行回顾性研究。纳入的主要标准是从骨髓标本中分离出结核分枝杆菌。
我们确定了22例经培养证实的骨髓结核分枝杆菌感染患者。该系列中发现的基础疾病包括4例（18%）实体器官移植、2例（9%）HIV感染和3例（14%）糖尿病。12例患者（55%）未发现危险因素。组织病理学结果显示，19例患者（86%）为肉芽肿，3例（14%）为干酪样肉芽肿。11例患者（50%）预后良好，10例（45%）在住院期间死亡，1例失访。对于完成治疗方案的患者，治疗持续时间为12个月。
从骨髓标本中分离出结核分枝杆菌表明疾病已播散，死亡率高，需要立即开始适当治疗。
