Changes in bone marrow in malaria-a prospective study of 47 cases

Background: Bone marrow aspiration done in cases of repeated fever, fever of unknown origin, pancytopenia to detect Malaria parasite in bone marrow. The study was undertaken to evaluate the role of bone marrow aspiration in establishing the etiology of Plasmodium vivax in cases of pancytopenia or thrombocytopenia in recurrent fever or fever of unknown origin.Methods: Patients of different age groups presenting with recurrent fever or fever of unknown origin with pancytopenia or thrombocytopenia from Jan 2015 to Oct 2017. Out of the 108 bone marrow aspirations abiding the above criteria 47 showed presence of Plasmodium vivax trophozoites in bone marrow.Results: The age of patients varied from 8 months to 65 years. 47 cases showed presence of Plasmodium vivax trophozoites, mainly with hyperplastic marrow showing normoblastic and megaloblastic hyperplasia, presence of hemophagocytosis in 6 cases and also 2 cases showing increase in plasma cells.Conclusions: Bone marrow aspiration studies are of vital importance in diagnosing malarial infection in endemic areas as being one of the cause of pancytopenia or thrombocytopenia.

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Fever of unknown origin and the role of Plasmodium vivax in Sao Paulo

BMJ Case Reports ◽

10.1136/bcr-2013-200189 ◽

2013 ◽

Vol 2013 (jul05 1) ◽

pp. bcr2013200189-bcr2013200189

Author(s):

M. R. Bacci ◽

J. A. B. Santos ◽

N. C. P. Zing ◽

F. B. Bragatto

Keyword(s):

Plasmodium Vivax ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

Sao Paulo ◽

São Paulo

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Bone Marrow Aspiration/Biopsy in the Evaluation of Fever of Unknown Origin in Patients with AIDS

Infectious Disorders - Drug Targets ◽

10.2174/1871526520666200705212903 ◽

2020 ◽

Vol 20 ◽

Author(s):

Mahboubeh Hajiabdolbaghi ◽

Bahar Ataeinia ◽

Fatemeh Ghadimi ◽

SeyedAhmad SeyedAlinaghi ◽

Banafsheh Moradmand Badie ◽

...

Keyword(s):

Bone Marrow ◽

Diagnostic Tool ◽

Fever Of Unknown Origin ◽

Opportunistic Infections ◽

Bone Marrow Aspiration ◽

Unknown Origin ◽

Aspiration Biopsy ◽

Diagnostic Tools ◽

Aids Patients ◽

Cell Counts

Background: HIV can interrupt the normal development of bone marrow cell lines. Bone marrow aspiration/biopsy (BMA/B) has been described as a diagnostic tool in AIDS patients with fever of unknown origin (FUO). In this study, we aimed to study patients with AIDS who had undergone a BMA/B to investigate FUO and describe the pathologies diagnosed in the biopsy. Methods: Thirty-four BMA/B samples were collected from AIDS patients admitted for workup of FUO to the infectious disease ward of a tertiary referral HIV center in Tehran, Iran, between September 2014 and September 2015. Data including age, sex, duration of disease, CD4 cell counts, hepatitis B (HBV) and C (HCV) coinfection, the primary presentation of AIDS, and the treatment history were retrieved and analyzed. Patients underwent BMA/B. An expert pathologist reviewed the BMA/B specimens. Results: The mean age of the patients was 37.5 years (range, 26-56), and 27 (79%) were men. Twenty-seven (79%) patients contracted HIV from injection drug use, and 7 (21%) via sexual transmission. Only 3 (9%) of the BMA/B examinations were normal. Hypocellular bone marrow was diagnosed in 22 (65%) patients. Other pathologies included granulomas in 6 (18%), hematologic malignancies in 2 (6%), and leishmaniasis Aspergillosis, each in 1 (3%) patient. Six (17%) of the specimens were found to have tuberculosis infections. Conclusion: Hypocellular bone marrow was the most common pathology on BMA/B examinations, followed by the presence of granulomas. Tuberculosis, Aspergillosis, and Leishmaniasis were the opportunistic infections diagnosed on BMA/B specimens. Our results support BMA/B as an appropriate diagnostic tool for early diagnosis of opportunistic infections and malignancies in AIDS. BMA/B is indispensable in the armament of diagnostic tools of the physicians managing AIDS patients.

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Diagnosis of Disseminated Adenocarcinoma by Bone Marrow Aspiration in a Dog with Leukoerythroblastosis and Fever of Unknown Origin

Veterinary Clinical Pathology ◽

10.1111/j.1939-165x.1998.tb01024.x ◽

1998 ◽

Vol 27 (3) ◽

pp. 80-84 ◽

Cited By ~ 7

Author(s):

Kristin L. Henson ◽

A. Rick Alleman ◽

Leslie E. Fox ◽

Lauren J. Richey ◽

William L. Castleman

Keyword(s):

Bone Marrow ◽

Fever Of Unknown Origin ◽

Bone Marrow Aspiration ◽

Unknown Origin

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Bone marrow sarcoidosis with pancytopenia and renal failure presenting as fever of unknown origin: the pivotal role of 18F-FDG-PET/CT in lesion detection

Journal of Nippon Medical School ◽

10.1272/jnms.jnms.2021_88-307 ◽

2020 ◽

Author(s):

Naoto Matsuda ◽

Syun Iida ◽

Yukitomo Ogino ◽

Noboru Saito ◽

Masahiro Yasutake

Keyword(s):

Bone Marrow ◽

Renal Failure ◽

Fdg Pet ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

Lesion Detection ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Positron emission tomography and reframing vasculitis as a spectrum of disease when investigating a patient with a fever of unknown origin

BMJ Case Reports ◽

10.1136/bcr-2018-224540 ◽

2018 ◽

pp. bcr-2018-224540

Author(s):

Farah Shahi ◽

Anda Samson

Keyword(s):

Positron Emission Tomography ◽

Bone Marrow ◽

Fever Of Unknown Origin ◽

Vision Loss ◽

Age Groups ◽

Unknown Origin ◽

Emission Tomography ◽

High Dose ◽

Temporal Artery Biopsy ◽

Positron Emission

A retired businessman presented to the infectious diseases department with a history of ongoing fevers and myalgia and raised inflammatory markers. This continued despite adequate antibiotic treatment of an epididymo-orchitis. Extensive investigations, including bone marrow and liver biopsies and a positron emission tomography, did not reveal a cause but showed reactive change in the bone marrow. Later, he developed a vasculitic rash and vision loss due to non-arteritic anterior ischaemic optic neuropathy. High-dose steroids were immediately initiated. A temporal artery biopsy was performed, which confirmed a healing large vessel vasculitis, possibly giant cell arteritis. He has responded very well to therapy. We must better appreciate the limitations of positron emission tomography in investigating a fever of unknown origin. The case also encourages awareness of autoimmune disorders as the leading category of causative diseases for this in older age groups.

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Role of bone marrow biopsy for fever of unknown origin in the contemporary Australian context

Internal Medicine Journal ◽

10.1111/imj.14147 ◽

2019 ◽

Vol 49 (7) ◽

pp. 850-854 ◽

Cited By ~ 2

Author(s):

Frank S. Hong ◽

Lucy C. Fox ◽

Khai Li Chai ◽

Kay Htun ◽

Danielle Clucas ◽

...

Keyword(s):

Bone Marrow ◽

Bone Marrow Biopsy ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

Australian Context

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Patients with fever of unknown origin (FUO): diagnosis by nuclear medicine imaging

Nuklearmedizin ◽

10.1055/s-0038-1623872 ◽

2001 ◽

Vol 40 (03) ◽

pp. 59-70 ◽

Cited By ~ 13

Author(s):

W. Becker ◽

J. Meiler

Keyword(s):

Nuclear Medicine ◽

Fever Of Unknown Origin ◽

Tumor Imaging ◽

White Blood Cells ◽

Unknown Origin ◽

Final Diagnosis ◽

Recurrent Fever ◽

Nuclear Medicine Imaging

SummaryFever of unknown origin (FUO) in immunocompetent and non neutropenic patients is defined as recurrent fever of 38,3° C or greater, lasting 2-3 weeks or longer, and undiagnosed after 1 week of appropriate evaluation. The underlying diseases of FUO are numerous and infection accounts for only 20-40% of them. The majority of FUO-patients have autoimmunity and collagen vascular disease and neoplasm, which are responsible for about 50-60% of all cases. In this respect FOU in its classical definition is clearly separated from postoperative and neutropenic fever where inflammation and infection are more common. Although methods that use in-vitro or in-vivo labeled white blood cells (WBCs) have a high diagnostic accuracy in the detection and exclusion of granulocytic pathology, they are only of limited value in FUO-patients in establishing the final diagnosis due to the low prevalence of purulent processes in this collective. WBCs are more suited in evaluation of the focus in occult sepsis. Ga-67 citrate is the only commercially available gamma emitter which images acute, chronic, granulomatous and autoimmune inflammation and also various malignant diseases. Therefore Ga-67 citrate is currently considered to be the tracer of choice in the diagnostic work-up of FUO. The number of Ga-67-scans contributing to the final diagnosis was found to be higher outside Germany than it has been reported for labeled WBCs. F-l 8-2’-deoxy-2-fluoro-D-glucose (FDG) has been used extensively for tumor imaging with PET. Inflammatory processes accumulate the tracer by similar mechanisms. First results of FDG imaging demonstrated, that FDG may be superior to other nuclear medicine imaging modalities which may be explained by the preferable tracer kinetics of the small F-l 8-FDG molecule and by a better spatial resolution of coincidence imaging in comparison to a conventional gamma camera.

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