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

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 to investigate 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 an infectious etiology from July 2014 to June 2018 was done. Detailed history, clinical examination and hematological parameters at presentation were 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 for 35%, 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 most common clinical finding was splenomegaly (66%). Conclusion: Bone marrow examination is an important diagnostic tool to delineate etiological diagnosis in infectious conditions, particularly those presenting with PUO. Moreover, it is particularly important if urgent diagnosis is required or if alternate diagnostic modalities have not revealed a reason for PUO.