Bone Marrow Cultures: Their Value in Diagnosing Fungal and Mycobacterial Infection in Patients with Cancer

Bone marrow cultures were studied as an aid in the diagnosis of fungal and mycobacterial infections in patients with cancer and a fever of unknown origin. In the period of January 1970-September 1980, 38 (21%) of 1,825 specimens were positive for fungi; the fungus from the specimens of 10 patients was pathogenic. Six (<1%) of 1,542 specimens tested were positive for mycobacteria; the Mycobacterium from the specimens of three patients was pathogenic. Bone marrow cultures that were positive for fungi and mycobacteria were useful in making diagnoses that resulted in early therapy only in patients with coccidioidomycosis and histoplasmosis. On the few occasions when the bone marrow cultures of patients with disseminated mycobacteriosis and fungal infections were positive for fungi and mycobacteria, this diagnosis had already been established by other methods. The results of this experience suggest that early involvement of the bone marrow in infection occurs in patients with coccidioidomycosis and histoplasmosis, in contrast to other fungal infections in which bone marrow cultures usually remain sterile even in the presence of disseminated disease.