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Utility of bone marrow culture and biopsy in the diagnosis of disseminated infections in AIDS
Author(s) -
Keiser Philip,
Rademacher Steven,
Smith James W.
Publication year - 1997
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/(sici)1096-8652(199709)56:1<1::aid-ajh1>3.0.co;2-u
Subject(s) - medicine , hematocrit , bone marrow , retrospective cohort study , biopsy , hematology , multivariate analysis , surgery
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. J. Hematol. 56:1–4, 1997. © 1997 Wiley‐Liss, Inc.