Bone marrow aspirate microscopy v. bone marrow trephine biopsy microscopy for detection of Mycobacterium tuberculosis infection
| Autor: | Jennifer Vaughan, Nazeer A Alli, T Pheeha, Qanita Sedick |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Pathology
medicine.medical_specialty Bone marrow trephine Tuberculosis medicine.diagnostic_test biology business.industry General Medicine Gold standard (test) medicine.disease biology.organism_classification Mycobacterium tuberculosis medicine.anatomical_structure Biopsy Medicine Sputum Bone marrow Radiology medicine.symptom business Chest radiograph |
| Zdroj: | South African Medical Journal; Vol 105, No 9 (2015); 773-775 SAMJ: South African Medical Journal, Volume: 105, Issue: 9, Pages: 773-775, Published: SEP 2015 |
| ISSN: | 2078-5135 0256-9574 |
| Popis: | Background. Tuberculosis (TB) remains a global health problem. According to the 2013 Global Report on Tuberculosis, 8.6 million people developed TB in 2012 and 1.3 million died from the disease. An estimated 13% of people who developed TB in 2012 were HIV-positive, and 75% of these lived in Africa. While pulmonary TB is the commonest form of Mycobacterium tuberculosis infection, extrapulmonary TB is increasingly being detected in HIV-positive patients. Definitive diagnosis of disseminated TB is a challenge owing to atypical presentations and diagnostic difficulties (negative chest radiograph and sputum microscopy and culture). A rapid diagnosis of disseminated TB is desirable, as early initiation of treatment can reduce mortality. Although TB culture is the gold standard for diagnosis of TB, it has a long turnaround time (up to 6 weeks). Objectives. To identify a potentially faster and more effective diagnostic strategy for disseminated TB. Methods. A retrospective 18-month review, conducted at a tertiary hospital, comparing histological findings of an auramine O-stained bone marrow aspiration (BMA) smear and a bone marrow trephine (BMT) biopsy specimen with the gold standard of TB culture. Results. Microscopic examination of BMA smears and BMT biopsy specimens offers a rapid diagnostic strategy, with results available on the same day for the former and within 4 days for the latter. BMT histological examination had a significantly higher detection rate than BMA auramine O staining compared with TB culture. Conclusion. We recommend that BMT biopsies remain an essential part of the diagnostic work-up for disseminated TB. |
| Databáze: | OpenAIRE |
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