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Am. J. Trop. Med. Hyg., 75(5), 2006, pp. 960-963
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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UTILITY OF POLYMERASE CHAIN REACTION IN DIAGNOSIS OF TUBERCULOSIS FROM SAMPLES OF BONE MARROW ASPIRATE

URVASHI B. SINGH*, N. VIJAYA BHANU, V. NAGA SURESH, JYOTI ARORA, TANU RANA, AND PRADEEP SETH
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India; Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, Maryland

Fever of unknown origin (FUO) poses a diagnostic challenge to the clinicians, with a differential diagnosis as varied as neoplastic and infectious diseases. In developing countries, the infectious causes are responsible for more cases of FUO, with tuberculosis as one of the main causes of classic FUO. Disseminated tuberculosis with negative pulmonary findings is a diagnostic problem. This study examines the diagnostic utility of the polymerase chain reaction (PCR) in samples of bone marrow aspirate in 85 patients presenting with diverse clinical symptoms. Using primers specific for Mycobacterium tuberculosis, tubercular etiology was detected in 33% of patients clinically suspected of tuberculosis while culture on Lowenstein-Jensen medium grew M. tuberculosis in only one patient (2.5%). None of these patients had been diagnosed by microscopy. Clinical improvement with ATT was observed in 85% of the patients with positive PCR. PCR demonstrated much higher sensitivity and specificity, thereby facilitating early therapeutic decisions for suspected extrapulmonary tuberculosis.

Received April 25, 2006. Accepted for publication July 19, 2006.

* Address correspondence to Urvashi B. Singh, Assistant Professor, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, 110029, India. E-mail: urvashi00{at}hotmail.com

Authors’ addresses: Urvashi B. Singh, Jyoti Arora, Tanu Rana, and Pradeep Seth, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, 110029, India, Telephone: +91-11-2658 8500, Fax: +91-11-2658 8641, E-mails: urvashi00{at}hotmail.com, mailjyoti09{at}yahoo.co.in, tanurana{at}gmail.com, sethpradeep{at}hotmail.com. N. Vijaya Bhanu and V. Naga Suresh, Molecular Medicine Branch, NIDDK, National Institutes of Health Bethesda, MD 20892, E-mails: BhanuN{at}intra.niddk.nih.gov, vnsuresh{at}hotmail.com.






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Copyright © 2006 by the American Society of Tropical Medicine and Hygiene.