The Role of the Bone Marrow Study in Typhoid Fever with Pancytopenia

Authors

  • Hisham Arif Getta College of Medicine, Sulaimany University

Keywords:

Typhoid fever, pancytopenia, Bone marrow

Abstract

Background: Typhoid fever is an endemic infectious disease in Sulaimanyia city in Kurdistan region of Iraq. Last years we observe there are remarkable haematological changes associated with this disease. Pancytopenia was one of these changes. The aim of this study was to evaluate the role of bone marrow study in typhoid fever with pancytopenia.

Methods: In this prospective study only culture positive enteric fever patients were taken. For all patients CBC and blood Film were done. Bone marrow study including aspirate and biopsy was done for all patients with peripheral blood pancytopenia.

Result: Two thousands culture positive enteric fever patients were taken into this study. Presenting symptoms included mainly fever and rigor. The peripheral blood of these patients revealed different haematological changes, like normocytic anaemia, leucopenia, bicytopenia and pancytopenia. Pancytopenia was in 127 (6.3%) patients. Bone marrow was active in all patients. Histiocytes are increased in activity in 55 (43%) cases; only in 17 (13%) cases haemophagocytosis was seen. No granuloma seen in all cases. Majority of the patients regain the normal blood parameters values within two to eight weeks.

Conclusion: Bone marrow study has no clear role for explanation the peripheral blood pancytopenia in typhoid fever. There is no indication for bone marrow study for culture positive typhoid fever with pancytopenia, unless the pancytopenia is persistent. Most probably the pancytopenia is caused by peripheral blood factor.

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References

Chowta MN, Chowta NK. Study of Clinical Profile and Antibiotic Response in Typhoid Fever. Indian J Med Microbiol 2005; 23:125-7.

Turan Buzğan, Ömer Evirgen, Hasan Irmak, Hasan Karsen, Hayrettin Akdeniz. Case of Typhoid Fever Presenting with Multiple Complications.Eur J Gen Med 2007; 4:83-6.

Gilman RH, Terminel M, Levine MM, Hernandez-Mendoza P, Hornick RB.Relative efficacy of blood, urine, rectal swab, bone marrow, and rose-spot Cultures for recovery of Salmonella typhi in typhoid fever. Lancet 1975; 1:1211-13.

Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ. Typhoid Fever.N Engl J Med 2002; 347:1770-82

Butler T, Islam A, Kabir I, Jones PK. Patterns of morbidity and mortality in typhoid fever dependent on age and Typhoid fever complications gender: a review of 552 hospitalized patients with diarrhea. Rev Infect Dis 1991; 13:85-90

Chamber HF. Infectious Diseases: Bacterial and Chlamydial. In: Tierney LM, McPhee SJ, Papadakis MA, eds. current Medical Diagnosis and Treatment. 37th ed. London: Prentice Hall International Inc 1998:1267-

Wg Cdr S Gupta, WgCdr A Handa. Profile of Culture Positive Enteric Fever from Bangalore. MJAFI 2009; 65: 328-1.

Joseph James, Tarun Kumar Dutta AND S. Jayanthi. Correlation of Clinical and Hematologic Profiles with Bone Marrow Responses in Typhoid Fever.Am. J. Trop. Med. Hyg 1997; 57: 313-6.

R Sood, S Roy, P Kaushik. Typhoid fever with severe pancytopenia. Postgraduate medical journal 1997;73:41-2.

Henter JI, Arico M, Egeler RM et al. A treatment protocol for hemophagocytic lymphohistiocytosis. Med Peddiatr Oncol 1997; 28:342-7

Pta MD, S Tripathi MD, V Tilak MD, B D Bhatia MD. A study of clinico-haematological profiles of pancytopenia in children. Tropical Doctor2008; 38:241-3

Dutta TK, Ghotekar LH. Atypical manifestations of typhoid fever. J Postgrad Med 2001; 47:248-51.

Khosla SN, Anand A, Singh U, Khosla A. Haematological profile in typhoid fever. Trop Doct 1995; 25:156-8.

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Published

2018-10-30

How to Cite

Getta, H. A. (2018). The Role of the Bone Marrow Study in Typhoid Fever with Pancytopenia. Zanco Journal of Medical Sciences (Zanco J Med Sci), 14(3 Special), 36–39. Retrieved from https://zjms.hmu.edu.krd/index.php/zjms/article/view/503

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Original Articles