Role of Bone Marrow Examination in the Evaluation of Infections: Clinico-Hematological Analysis in a Tertiary Care Centre

Abstract

Objective: 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 toinvestigate the usefulness of BME and to evaluate the etiological and clinico-hematological profile in cases of bone marrow infections.Material and Method: This was a retrospective study where bone marrow cases were retrieved and a review of bone marrow findings with aninfectious etiology from July 2014 to June 2018 was done. Detailed history, clinical examination and hematological parameters at presentationwere recorded. Clinico-hematological correlation using descriptive statistics was performed.Results: The study included 55 cases, on analysis of which the maximum number of infections were those of leishmaniasis accounting for35%, 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 mostcommon clinical finding was splenomegaly (66%).Conclusion: Bone marrow examination is an important diagnostic tool to delineate etiological diagnosis in infectious conditions, particularlythose presenting with PUO. Moreover, it is particularly important if urgent diagnosis is required or if alternate diagnostic modalities have notrevealed a reason for PUO.