Mycobacteria and cryptococci cultured from the buffy coat of AIDS patients prior to symptomatology: a rationale for early therapy.

Culture of the buffy coat layer of the peripheral blood of 14 AIDS patients demonstrated sustained mycobacteremia or fungemia: 11 with Mycobacterium avium-intracellulare, 2 with Cryptococcus neoformans, and one with Mycobacterium tuberculosis. The early detection of these agents prior to the onset of overt symptomatology of disseminated infection due to these microorganisms allowed speculations on an early phase bacteremia and the proposal of prompt inception of antimicrobial therapy while the microbial burden is still manageable. The method also obviates the need for more invasive techniques.