Bone Marrow Culture Vs Blood Culture in FUO

Abstract

Introduction:Bone marrow culture is considered superior to blood culture in evaluation of FUO. The
aim of this study was to compare the usefulness of these two cultures.
Methods:A one year prospective cross sectional study was conducted to fi nd out the usefulness
of bone marrow culture and blood culture in the diagnosis of FUO. Marrow aspirates in each case
were sent for bacterial, myocbacterial and fungal culture. Simultaneously venous blood was sent for
bacterial culture. The results of BMCs and BCs were compared.
Results:Total 57 cases of FUO were included in the study. Male female ratio was 1.22:1. Age range
was fi ve to 83 years (median 30). Duration of fever was 21 to 365 days. Bacterial growth was seen in
nine cases (15.78%) of BMCs and in three cases (5.26%) of corresponding BCs. Fungal or myocbacterial
growth was not seen. Salmonella typhi was the commonest organism isolated in BMCs (three cases)
followed by Staphylococcus aureus (two cases), Escherichia coli, Non fermenting Gram negative
bacilli, Enterococcus species and Salmonella paratyphi–A (one case each). Two cases of Salmonella
typhi and one case of Salmonella paratyphi–A were isolated in BCs.
Conclusions:BMCs are more useful than BCs in evaluation of patients with FUO, especially in cases
of salmonella infection and are particularly important when the patient has already taken antibiotics.
In immuno-competent patients presenting with FUO, BMCs for mycobacteria or fungi is unlikely to
yield any growth.
Key Words: blood culture, bone marrow culture, fever of unknown origin