Bone marrow in HIV infection. A comparison of fluorescent staining and cultures in the detection of mycobacteria.

Fifty-one bone marrow aspirates and biopsies from 47 human immunodeficiency virus-(HIV) infected patients (42 with acquired immune deficiency syndrome [AIDS], 5 with AIDS-related complex [ARC]) were processed by standard methods for smears and paraffin sections. Aspirates were cultured for Mycobacteria. The sections, imprints, and smears were examined by fluorescent microscopy with the use of Truant's modification of the auramine-rhodamine stain. Mycobacterial cultures had positive results from 35%. Sensitivity of fluorescent staining was 72% and specificity was found to be 94%. If the fluorescent stain had positive results, the positive predictive value for recovering Mycobacteria on culture was 87%. Fluorescent microscopy with the use of Truant's auramine-rhodamine staining of routinely processed bone marrow aspirates and biopsies is a fairly sensitive, very specific, and rapid technique for determining the presence of Mycobacteria in bone marrow specimens from patients with HIV infection.