Utility of bone marrow culture and biopsy in the diagnosis of disseminated infections in AIDS

✍ Scribed by Keiser, Philip; Rademacher, Steven; Smith, James W.

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 23 KB
• Volume: 56
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/(sici)1096-8652(199709)56:1<1::aid-ajh1>3.0.co;2-u

✦ Synopsis

Bone marrow examination (BME) has been used as a diagnostic test of last resort in HIV infected patients. Identifying factors that would increase the diagnostic yield of BME would be useful. A retrospective cohort study was done to determine the predictive value of BME for disseminated infection in 133 patients with HIV infection in a 4-year period at an active HIV clinical center. Thirty-two percent of the cases had evidence of a disseminated infection on BME but only 10% of cases had a diagnosis made exclusively by BME. Multivariate analysis demonstrated that a positive result was more likely in those patients with fewer than 50 CD4 cells/mm 3 and those with a hematocrit of less than 25% (P < 0.01). BME can be a useful, low-risk diagnostic procedure in selected patients with HIV infection who are ill with a low CD4 count and/or have a hematocrit less than 25%. A diagnosis can usually be made by other means, suggesting that this test should be limited to those in whom other diagnostic modalities have been exhausted. Am.