Bone marrow culture vs. blood culture in FUO.

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 find 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 five 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. CONCLUSION 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.