Bone Marrow Biopsy in Fever of Unknown Origin

Bone marrow biopsy is sometimes included in the diagnostic work-up for fever of unknown origin (FUO), but how useful is it among immunocompetent adults? To answer this question, investigators at a tertiary care center in France reviewed data from all 280 immunocompetent adults who were hospitalized with FUO between 1995 and 2005; 130 of these patients (46.4%) underwent bone marrow biopsy during the hospitalization.

Bone marrow culture was negative in all cases, including those in which TB was suspected. In contrast, histologic examination of the bone marrow led to a diagnosis in 31 patients, for a diagnostic yield of 24%. Twenty-five of these patients (81%) were found to have hematologic malignant disease, whereas only 3 had fever with an in…