Dance D A, White N J, Suputtamongkol Y, Wattanagoon Y, Wuthiekanun V, Chaowagul W
Bangkok Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Thailand.
Trans R Soc Trop Med Hyg. 1990 Jul-Aug;84(4):585-7. doi: 10.1016/0035-9203(90)90050-o.
We have evaluated prospectively the contribution of bone marrow culture to the diagnosis of melioidosis. Bone marrow (BMC) and blood cultures (BC) were collected concurrently from 105 patients with suspected acute, severe melioidosis. 67 patients were subsequently proved to have the disease whilst other significant organisms were isolated from these specimens in 5 cases. Overall, 67.2% of BC and 64.2% of BMC from melioidosis patients grew Pseudomonas pseudomallei. Time to positivity did not differ significantly in paired BC and BMC specimens. These results do not support the routine use of BMC in the diagnosis of acute, severe melioidosis. In one patient with pulmonary melioidosis, however, blood cultures were repeatedly negative, whilst bone marrow grew P. pseudomallei, and this preceded the development of a distant focus of infection. This suggests that culture of bone-marrow may be of value in certain blood culture-negative patients with melioidosis.
我们前瞻性地评估了骨髓培养在类鼻疽诊断中的作用。从105例疑似急性重症类鼻疽患者中同时采集骨髓培养物（BMC）和血培养物（BC）。随后证实67例患者患有该病，另有5例从这些标本中分离出其他重要病原体。总体而言，类鼻疽患者的血培养物中有67.2%、骨髓培养物中有64.2%培养出类鼻疽杆菌。配对的血培养物和骨髓培养物标本的阳性培养时间差异无统计学意义。这些结果不支持在急性重症类鼻疽诊断中常规使用骨髓培养。然而，在1例肺类鼻疽患者中，血培养多次阴性，而骨髓培养出类鼻疽杆菌，且这发生在远处感染灶出现之前。这表明骨髓培养在某些血培养阴性的类鼻疽患者中可能具有价值。
