Utility of bone marrow biopsy for rapid diagnosis of febrile illnesses in patients with human immunodeficiency virus infection
| Autor: | Jb, Cousar, D'Agata E, Dw, Haas, Ar, Kallianpur, Dl, Lakey, Rs, Larson, James Luther |
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| Předmět: |
Adult
Male Microbiological Techniques Fever Biopsy Histoplasma HIV Infections Leukocyte Count Bone Marrow Humans Prospective Studies Coloring Agents Histoplasmosis Lymphoma AIDS-Related Mycobacterium avium-intracellulare Infection Retrospective Studies Chi-Square Distribution AIDS-Related Opportunistic Infections L-Lactate Dehydrogenase Histocytochemistry Pneumonia Pneumocystis Anemia Bone Marrow Examination Logistic Models Hematocrit Multivariate Analysis Female Forecasting |
| Zdroj: | Europe PubMed Central |
| Popis: | Histochemical staining of bone marrow biopsy samples for microorganisms may provide a presumptive diagnosis weeks before culture.To identify predictors of histochemical positivity, we reviewed 161 bone marrow biopsies from febrile patients with human immunodeficiency virus (HIV) infection.By multivariate analysis, both hematocrit value30% and white blood cell count4,000/mm3 predicted biopsy positivity by culture or staining, but only anemia predicted histochemical stain positivity. Of cases with serum lactate dehydrogenase (LDH) levels600 U/L, histoplasmosis was diagnosed in 31.6% versus 7.8% with lower LDH levels. Among histoplasmosis cases, staining showed fungi in all, with LDH levels600 U/L versus 44.4% with lower levels.Bone marrow biopsy will most likely provide a rapid diagnosis in patients with anemia. Markedly elevated LDH levels suggest stain positivity for Histoplasma capsulatum. Histopathologic patterns may also guide empiric therapy. |
| Databáze: | OpenAIRE |
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