Erythrophagocytosis in Bone Marrow: A Clue to Pyrexia of Unknown Origin

Bone marrow (BM) is usually done to investigate the patients for Pyrexia of Unknown Origin (PUO). However, only 16.5 % of cases reveal any diagnostic information. Increasing incidence of atypical presentations are seen in typhoid. Careful examination of BM to pick up clues for diagnosis is important We report a case of a 15 year old female who presented with fever since associated with altered sensorium, gum bleeding and loose stools. Hematological findings revealed pancytopenia with macrocytic anemia with erythrophagocytosis in BM aspirates. A diagnosis of typhoid was made with a positive typhi dot IgM. The authors present this case to highlight the importance of simple BM findings of erythrophagocytosis and how awareness about this feature can point towards the right diagnosis in the midst of atypical clinical and hematological features. J Microbiol Infect Dis 2018; 8(2):73-75.