{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:24:07Z","timestamp":1787775847797,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context:<\/jats:title>\n                    <jats:p>Bone marrow examination (BME) is an invaluable tool for cases with pyrexia of unknown origin and pancytopenia. However, it is under-utilized for diagnosing infectious etiology and there is a paucity of literature regarding its role in infective pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>This study aims to bring to light the role of BME in diagnosing infectious pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings and Design:<\/jats:title>\n                    <jats:p>A retrospective study was carried out on bone marrow aspirates (BMAs) sent to the hematology department over the past 4 years. Clinical details, peripheral smears and BMA were retrieved from the records and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods:<\/jats:title>\n                    <jats:p>Leishman-stained peripheral smears and BMA were studied along with bone marrow biopsy wherever feasible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 52 cases were studied. The most common clinical presentation was fever, clinical finding was splenomegaly and hematological finding was anemia. Based on the morphological findings in combination with clinical history, cases were categorized into\u2013parasitic (26.9%), viral (23.1%), tubercular (11.5%), and nonspecific infections (38.5%). Parasites such as\n                      <jats:italic toggle=\"yes\">Leishmania donovani<\/jats:italic>\n                      , microfilaria, plasmodium falciparum, and vivax were reported in 14\/52 (27%) cases. Associated BMA findings were plasmacytosis, eosinophilia, reactive lymphocytosis, or dyserythopoiesis. In 38% (20\/52) cases, no specific cause of infection was found in the bone marrow. These patients showed histiocytosis, hemophagocytosis, maturation arrest in myeloid lineage, relative myeloid hyperplasia, dysmyelopoiesis, toxic granulation\/vacuolation in myeloid cells, lymphocytosis, increased plasma cells or monocytosis in marrow.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Increased histiocytes, hemophagocytosis, dysplastic changes, maturation arrest, relative myeloid hyperplasia or reactive plasmacytosis, lymphocytosis, and monocytosis are BMA features which must alert the pathologist towards an infectious disease process, a knowledge of these changes can help extend the scope of BME beyond hemato-lymphoid malignancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmau.jmau_20_23","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T04:48:06Z","timestamp":1693975686000},"page":"114-119","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Morphological Spectrum of Bone Marrow Aspirates in Infections: A Clinico-Hematological Analysis"],"prefix":"10.4103","volume":"12","author":[{"given":"Divya","family":"Aggarwal","sequence":"first","affiliation":[{"name":"Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpi","family":"More","sequence":"additional","affiliation":[{"name":"Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritika","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Sikka","sequence":"additional","affiliation":[{"name":"Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrinalini","family":"Kotru","sequence":"additional","affiliation":[{"name":"Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,9,6]]},"reference":[{"key":"R1-20240921","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1179\/102453308X343446","article-title":"Hematological profile in pyrexia of unknown origin:Role of bone marrow trephine biopsy vis-\u00e0-vis aspiration","volume":"13","author":"Gupta","year":"2008","journal-title":"Hematology"},{"key":"R2-20240921","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1309\/AJCP50AEEYGREWUZ","article-title":"The differential diagnosis and bone marrow evaluation of new-onset pancytopenia","volume":"139","author":"Weinzierl","year":"2013","journal-title":"Am J Clin Pathol"},{"key":"R3-20240921","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/S1473-3099(09)70177-X","article-title":"Key gaps in the knowledge of Plasmodium vivax, a neglected human malaria parasite","volume":"9","author":"Mueller","year":"2009","journal-title":"Lancet Infect Dis"},{"issue":"Suppl 1","key":"R4-20240921","first-page":"86","article-title":"Hemostatic alterations in malaria","volume":"24","author":"Srichaikul","year":"1993","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"R5-20240921","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.thromres.2013.09.030","article-title":"Coagulopathy in malaria","volume":"133","author":"Angchaisuksiri","year":"2014","journal-title":"Thromb Res"},{"key":"R6-20240921","doi-asserted-by":"crossref","first-page":"e2015039","DOI":"10.4084\/mjhid.2015.039","article-title":"The utility of blood and bone marrow films and trephine biopsy sections in the diagnosis of parasitic infections","volume":"7","author":"Miller","year":"2015","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"R7-20240921","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.trstmh.2010.09.006","article-title":"Diagnosis of visceral leishmaniasis","volume":"105","author":"Srivastava","year":"2011","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"R8-20240921","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1046\/j.1365-2559.2000.00965.x","article-title":"Bone marrow manifestations of infections and systemic diseases observed in bone marrow trephine biopsy review","volume":"37","author":"Diebold","year":"2000","journal-title":"Histopathology"},{"key":"R9-20240921","doi-asserted-by":"crossref","first-page":"861032","DOI":"10.1155\/2013\/861032","article-title":"Visceral leishmaniasis with associated common, uncommon, and atypical morphological features on bone marrow aspirate cytology in nonendemic region","volume":"2013","author":"Chandra","year":"2013","journal-title":"J Trop Med"},{"key":"R10-20240921","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1159\/000324961","article-title":"Bone marrow aspiration findings in Kala-Azar","volume":"54","author":"Daneshbod","year":"2010","journal-title":"Acta Cytol"},{"key":"R11-20240921","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1159\/000337446","article-title":"Morphological variations in microfilaria of Wuchereria bancrofti in cytology smears:A morphometric study of 32 cases","volume":"56","author":"Kaushal","year":"2012","journal-title":"Acta Cytol"},{"key":"R12-20240921","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.medmal.2012.09.006","article-title":"Predictive value of the eosinophil counts in the biological diagnosis of lymphatic filariasis in French Polynesia","volume":"42","author":"Musso","year":"2012","journal-title":"Med Mal Infect"},{"key":"R13-20240921","first-page":"13","article-title":"Granulomas in bone marrow \u2013A study of fourteen cases","volume":"48","author":"Basu","year":"2005","journal-title":"Indian J Pathol Microbiol"},{"key":"R14-20240921","doi-asserted-by":"crossref","first-page":"231","DOI":"10.3126\/jpn.v2i3.6029","article-title":"Bone marrow evaluation in patients with fever of unknown origin","volume":"2","author":"Jha","year":"2012","journal-title":"J Pathol Nepal"},{"key":"R15-20240921","first-page":"17","article-title":"Role of bone marrow examination in the evaluation of infections:Clinico-hematological analysis in a tertiary care Centre","volume":"36","author":"Kumar","year":"2020","journal-title":"Turk Patoloji Derg"},{"key":"R16-20240921","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s13256-015-0552-5","article-title":"Acquired hemophagocytic syndrome related to parainfluenza virus infection:Case report","volume":"9","author":"Beffermann","year":"2015","journal-title":"J Med Case Rep"}],"updated-by":[{"DOI":"10.4103\/jmau.jmau_32_26","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000}}],"container-title":["Journal of Microscopy and Ultrastructure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmau.jmau_20_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:43:50Z","timestamp":1787773430000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmau.jmau_20_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,6]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/jmau.jmau_20_23","relation":{},"ISSN":["2213-879X","2213-8803"],"issn-type":[{"value":"2213-879X","type":"print"},{"value":"2213-8803","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,6]]},"assertion":[{"value":"2023-02-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}