Department of Pathology

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Browsing Department of Pathology by Author "Abrahams, Riezaah"

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    An evaluation of the diagnostic utility of bone marrow and peripheral blood cultures in patients with suspected disseminated Mycobacterium tuberculosis infection
    (Stellenbosch : Stellenbosch University, 2015-03) Abrahams, Riezaah; Wasserman, Elizabeth; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Pathology.
    ENGLISH ABSTRACT: Background Disseminated tuberculosis is defined as the involvement of two or more non-contiguous organ sites simultaneously. The aim of this study was to optimize, evaluate and compare the diagnostic utility of bone marrow aspirate culture and peripheral blood culture (PBC) for the diagnosis of disseminated tuberculosis. Methods This prospective descriptive, laboratory based study recruited patients suspected of having disseminated tuberculosis and who had both study specimens (peripheral blood and bone marrow aspirate) submitted for mycobacterial culture. Study specimens were processed according to standard routine laboratory practice with an additional tube of solid media (Löwenstein-Jensen agar) containing 0.5ml of growth supplement inoculated during sub-culture from the positive blood cultures. HIV status and bone marrow trephine histology results were obtained from the Laboratory Information System. Results A total of 96 patients were recruited. Mycobacterium tuberculosis complex was isolated from bone marrow culture and/or PBC in eight (8.3%) of the study patients. The yield of M. tuberculosis complex from bone marrow aspirate culture was 7% vs. 3% from PBC. The mean time to detection (TTD) of M. tuberculosis complex from sub-cultured solid media was more rapid for PBC (n=3) compared to bone marrow aspirate culture (n=7). The addition of growth supplement to solid media did not enhance amount of growth nor improved the TTD of M. tuberculosis complex. Conclusion Our findings support bone marrow as the specimen of choice for the diagnosis of disseminated tuberculosis, but could not indicate any advantage in sub-culturing positive specimens on enriched media.