Ambreen Zafar, Aslam Khan, Aiza Saadia, Saqib Qayyum Ahmad, Shahid Jamal


Background: Any fever with undetermined etiology and not showing spontaneous resolution in the anticipated period of self-limited infections is known as fever of unknown origin. Bone marrow biopsy is a useful technique for the diagnosis of prolonged fever in immunocompetent patients. The objective of present study was to evaluate bone marrow biopsy findings in fever of unknown origin.
Material & Methods: This was descriptive study carried out in Department of Histopathology & Hematology, Army Medical College, Rawalpindi, National University of Sciences and Technology, Islamabad, Pakistan. Duration of study was one year from January 2014 to December 2014. Bone marrow trephine biopsy was performed on 40 patients.
Results: Out of 40 patients 30 were males and 10 females. The age range of patients was from 7 to 85 years. Age group 20-30 years showed maximum number of patients. The most frequent finding on histopathological analysis was reactive changes (27.5%) followed by chronic granulomatous inflammation (22.5%), atypical mononuclear infiltrate (10%), aplastic anemia, hypocellular marrow and visceral leishmaniasis (7.5% each).
Conclusion: Morphological and histological examination of bone marrow has definitive role in the diagnosis of pyrexia of unknown origin. Nonetheless, yield of diagnosis can be improved if it is combined with other diagnostic modalities including radiological, microbiological and serological investigations.


Bone marrow biopsy; Granulomatous inflammation; Visceral leishmaniasis.

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