A stepwise approach is essential to evaluating pyrexia of unknown origin (PUO). When other investigations are negative, bone marrow examination is a valuable diagnostic tool in PUO. It is particularly helpful in patients with involvement of reticuloendothelial organs (e.g. cytopenia, splenomegaly), immunodeficiency states, or older age.
AkhtarWAwanSIshaqU, et al.Pyrexia of unknown origin and its aetiology in Pakistan. Trop Doct2022; 52: 567–571.
2.
PannuAKGollaRKumariS, et al.Aetiology of pyrexia of unknown origin in north India. Trop Doct2021; 51: 34–40.
3.
AroraNShuklaSVijaykumarD, et al.Pyrexia of unknown origin in HIV-negative adults from Himachal Pradesh (India): will you suspect disseminated histoplasmosis?Trop Doct2020; 50: 275–277.
4.
PannuAKBhallaA. Secondary hemophagocytic lymphohistiocytosis: think of the devil lurking!. Indian J Crit Care Med2022; 26: 545–546.
5.
PannuAKSinglaVSuriV, et al.Adult-onset still’s disease and fever of unknown origin in India. Clin Exp Med2022: 1–8. doi:10.1007/s10238-022-00903-3. Epub ahead of print.
6.
HotAJaissonIGirardC, et al.Yield of bone marrow examination in diagnosing the source of fever of unknown origin. Arch Intern Med2009; 169: 2018–2023.
7.
YadavBKPannuAKKumarR, et al.Fever of unknown origin in older adults: a prospective observational study from north India. J Assoc Physicians India2021; 69: 11–12.
8.
BenitoNNúñezAde GórgolasM, et al.Bone marrow biopsy in the diagnosis of fever of unknown origin in patients with acquired immunodeficiency syndrome. Arch Intern Med1997; 157: 1577–1580.
9.
HajiabdolbaghiMAtaeiniaBGhadimiF, et al.Bone marrow aspiration/biopsy in the evaluation of fever of unknown origin in patients with AIDS. Infect Disord Drug Targets2021; 21: 394–398.
10.
WangHYYangCFChiouTJ, et al.A “bone marrow score” for predicting hematological disease in immunocompetent patients with fevers of unknown origin. Medicine (Baltimore)2014; 93: e243.