Evaluation for usefulness of bone marrow study in fever of unknown origin

Kim, Yeong Sic; Lee, Woo In; Suh, Jin Tae; Lee, Hee Joo

Abstract

BACKGROUND
As the new diagnostic methods for evaluation of fever of unknown origin (FUO) have been developed, the clinical spectrum of FUO has been changed. Although bone marrow study was commonly used in the evaluation of FUO, it's value has not been established. We evaluated the value of bone marrow study for FUO patients. MATERIAL AND METHODS: The 53 patients with FUO who have been performed bone marrow study from 1991 to 1998 were studied, retrospectively. Radiologic, serologic, hematologic, biopsy of tissue, chemistry, molecular and microbiologic review were included in this study.
RESULTS
The etiology of FUO was identified in 31(58.5%) of the 53 patients through bone marrow examination. Of 53 patients, bacterial infection accounts for 12(22.6%); neoplasm 10(18.9%); SLE 3(5.7%); aplastic anemia 2(3.8%); drug induced 2(3.8%); necrotizing lymphadenitis 1(1.8%); hereditary spherocytosis 1(1.8%). Bone marrow examination as confirmative diagnostic method was valuable in 12(38.7%) of 31 patients who's etiology was identified. Of 53 patients, 22 persons (41.5%) showed no abnormal findings in marrow.
CONCLUSION
Bone marrow study for FUO was very useful to diagnose hematologic diseases and miliary tuberculosis, but it was considered to be a less useful method for the initial diagnosis for the other diseases.