Kumar Vijay, Bhatia Akanksha, Madaan Garima Baweja, Marwah Sadhna, Nigam A S
Department of Pathology, PGIMER, Dr. Ram Manohar Lohia Hospital, NEW DELHI, INDIA.
Turk Patoloji Derg. 2020;36(1):17-22. doi: 10.5146/tjpath.2019.01466.
Bone marrow examination (BME) is an important modality for investigation of case of pyrexia of unknown origin (PUO). However, its yield in the diagnosis of infections has not been extensively studied and its role has not been well established. The aim of the study was to investigate the usefulness of BME and to evaluate the etiological and clinico-hematological profile in cases of bone marrow infections.
This was a retrospective study where bone marrow cases were retrieved and a review of bone marrow findings with an infectious etiology from July 2014 to June 2018 was done. Detailed history, clinical examination and hematological parameters at presentation were recorded. Clinico-hematological correlation using descriptive statistics was performed.
The study included 55 cases, on analysis of which the maximum number of infections were those of leishmaniasis accounting for 35%, followed by HIV (29%) and tuberculosis (15%). Other etiological agents included fungal infections (histoplasmosis and aspergillosis), Enteric fever, Scrub typhus, parvovirus, falciparum malaria and filariasis. The most common clinical presentation was fever (80%) and the most common clinical finding was splenomegaly (66%).
Bone marrow examination is an important diagnostic tool to delineate etiological diagnosis in infectious conditions, particularly those presenting with PUO. Moreover, it is particularly important if urgent diagnosis is required or if alternate diagnostic modalities have not revealed a reason for PUO.
骨髓检查（BME）是不明原因发热（PUO）病例调查的重要手段。然而，其在感染诊断中的检出率尚未得到广泛研究，其作用也未得到充分确立。本研究的目的是调查骨髓检查的有用性，并评估骨髓感染病例的病因及临床血液学特征。
这是一项回顾性研究，检索骨髓病例，并对2014年7月至2018年6月有感染病因的骨髓检查结果进行回顾。记录详细病史、临床表现及就诊时的血液学参数。采用描述性统计进行临床血液学相关性分析。
该研究纳入55例病例，分析发现感染最多的是利什曼病，占35%，其次是HIV（29%）和结核病（15%）。其他病原体包括真菌感染（组织胞浆菌病和曲霉病）、伤寒、恙虫病、细小病毒、恶性疟和丝虫病。最常见的临床表现是发热（80%），最常见的临床体征是脾肿大（66%）。
骨髓检查是明确感染性疾病，特别是不明原因发热病例病因诊断的重要诊断工具。此外，在需要紧急诊断或其他诊断方法未揭示不明原因发热病因时，骨髓检查尤为重要。
