       Document 0439
 DOCN  M9610439
 TI    Detection of mycobacteria in bone marrow biopsy specimens taken to
       investigate pyrexia of unknown origin.
 DT    9601
 AU    Riley UB; Crawford S; Barrett SP; Abdalla SH; Diagnostic Bacteriology
       Department, St Mary's Hospital, London.
 SO    J Clin Pathol. 1995 Aug;48(8):706-9. Unique Identifier : AIDSLINE
       MED/96005876
 AB    AIMS--To investigate the value of bone marrow biopsy in the diagnosis of
       mycobacterial infection. METHODS--The culture results of 433 bone marrow
       samples taken between 1983 and 1992 were reviewed. The histopathology
       reports on bone marrow trephine specimens of culture positive samples
       and all those on HIV positive patients sent in 1992 were also reviewed.
       RESULTS--Fifty one specimens yielded Mycobacterium spp, 47 were obtained
       from HIV positive patients. Of the isolates, 42 were Mycobacterium
       avium-intracellulare (MAI), five were M tuberculosis (MTB), and the
       remaining four comprised a variety of atypical mycobacteria. All MAI
       positive samples were obtained from HIV positive patients, with the bone
       marrow being the only culture positive specimen in one third. Bone
       marrow yielded MTB only in patients from whom it was also isolated in
       other specimens. Eleven of 47 trephine specimens from positive bone
       marrow showed granulomata and nine showed acid-fast bacilli. No
       acid-fast bacilli were seen in the absence of granulomata.
       CONCLUSION--Bone marrow biopsy for mycobacterial culture should be
       reserved for severely immunosuppressed patients and should not be
       advocated for immunocompetent patients with suspected tuberculosis. Bone
       marrow biopsy still has a role in the investigation of pyrexia of
       unknown origin in HIV positive patients, despite the advent of
       mycobacterial blood culture techniques, particularly if these can be
       processed safely in automated systems.
 DE    Bone Marrow/*MICROBIOLOGY  Comparative Study  Fever of Unknown
       Origin/*MICROBIOLOGY  Human  HIV Infections/COMPLICATIONS  HIV
       Seropositivity/BLOOD/MICROBIOLOGY  Mycobacterium/*ISOLATION & PURIF
       Mycobacterium avium Complex/ISOLATION & PURIF  Mycobacterium
       tuberculosis/ISOLATION & PURIF  Mycobacterium Infections/COMPLICATIONS
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

