Contributions
Abstract: PB1892
Type: Publication Only
Background
Centre of Disease Control enlists more than 20 infections considered as Acquired Immunodeficiency Syndrome(AIDS) defining. Progression of the disease and falling CD4 counts are the most important risk factors in acquiring these infections. Most of the cases present with non specific symtoms including fever, respiratory and gastrointestinal manifestations . A bone marrow examination is helpful in estabilishing the diagnosis in many of these cases.
Aims
The aim of this study was to evaluate the incidence of marrow infections in HIV positive patients and to study their morphological spectrum.
Methods
This is a six year retrospective study carried out in a tertiary care hospital in North India. All bone marrow aspirates and biopsies from HIV positive patients were retrieved and evaluated for the presence of infectious etiology. Cytochemical stains like Acid Fast Bacillus, Periodic Acid Schiff, Gomori Methenamine Silver and Mucicarmine were performed wherever needed. The associated morphological features which may assist diagnosis were noted.
Results
Bone marrow samples (either aspirates or biopsies or both) were available in 185 HIV patients. Out of these, fifty three cases (33.5%) were associated with infections. The most common infection in these patients was Mycobacterium Tuberculosis (22.7%). In addition, five cases of Histoplasmosis (2.7%), two cases of Cryptococcosis, two cases of Leishmania donovanii, and one case of Plasmodium falciparum, Parvovirus and Microfilaria each were noticed. The morphological spectrum associated with infections in these cases included lymphoplasmacytic infiltrate(68%), granulomas(66%), macrophage infiltration, hemophagocytosis, gelationous marrow transformation and marrow hypoplasia. Two cases of M tuberculosis were associated with maturation arrest in the bone marrow. One case of Tuberculosis was associated with Non Hodgkin’s Lymphoma. Myelodysplasia was seen in association with Leishmania infection.
Conclusion
A wide spectrum of infections may be observed in HIV positive patients in the bone marrow. Bone marrow aspirate and biopsy are essential, rapid and cost effective techniques to arrive at the right diagnosis in such cases . Features like hypoplasia, myelodysplasia and maturation arrest may be attributable to infections.
Session topic: 29. Infectious diseases, supportive care
Keyword(s): Infection, Bone Marrow, AIDS/HIV
Abstract: PB1892
Type: Publication Only
Background
Centre of Disease Control enlists more than 20 infections considered as Acquired Immunodeficiency Syndrome(AIDS) defining. Progression of the disease and falling CD4 counts are the most important risk factors in acquiring these infections. Most of the cases present with non specific symtoms including fever, respiratory and gastrointestinal manifestations . A bone marrow examination is helpful in estabilishing the diagnosis in many of these cases.
Aims
The aim of this study was to evaluate the incidence of marrow infections in HIV positive patients and to study their morphological spectrum.
Methods
This is a six year retrospective study carried out in a tertiary care hospital in North India. All bone marrow aspirates and biopsies from HIV positive patients were retrieved and evaluated for the presence of infectious etiology. Cytochemical stains like Acid Fast Bacillus, Periodic Acid Schiff, Gomori Methenamine Silver and Mucicarmine were performed wherever needed. The associated morphological features which may assist diagnosis were noted.
Results
Bone marrow samples (either aspirates or biopsies or both) were available in 185 HIV patients. Out of these, fifty three cases (33.5%) were associated with infections. The most common infection in these patients was Mycobacterium Tuberculosis (22.7%). In addition, five cases of Histoplasmosis (2.7%), two cases of Cryptococcosis, two cases of Leishmania donovanii, and one case of Plasmodium falciparum, Parvovirus and Microfilaria each were noticed. The morphological spectrum associated with infections in these cases included lymphoplasmacytic infiltrate(68%), granulomas(66%), macrophage infiltration, hemophagocytosis, gelationous marrow transformation and marrow hypoplasia. Two cases of M tuberculosis were associated with maturation arrest in the bone marrow. One case of Tuberculosis was associated with Non Hodgkin’s Lymphoma. Myelodysplasia was seen in association with Leishmania infection.
Conclusion
A wide spectrum of infections may be observed in HIV positive patients in the bone marrow. Bone marrow aspirate and biopsy are essential, rapid and cost effective techniques to arrive at the right diagnosis in such cases . Features like hypoplasia, myelodysplasia and maturation arrest may be attributable to infections.
Session topic: 29. Infectious diseases, supportive care
Keyword(s): Infection, Bone Marrow, AIDS/HIV