Infection of bone marrow is uncommon. However, it may be a site of infection with bacteria or fungi or tuberculosis in patients with disseminated disease.
If a clotted specimen is received, emulsify the coagulated material using a sterile swab or loop.
A portion of ALL specimens should be forwarded for Mycobacteria (TB) culture.
Gram stain KOH Calcofluor white stain
|Blood Agar (BA)||CO2, 35°C x 48 hours|
|Chocolate Agar (CHOC)||CO2, 35°C x 48 hours|
|Wilkins Chalgren Agar (WC)||AnO2, 35°C x 48 hours|
|Sabouraud’s Heart Infusion Agar (SABHI)||O2, 30°C x 4 weeks|
|SABHI with Chloramphenicol (SABHI-C)||O2, 30°C x 4 weeks|
|Thioglycolate broth (THIO)||O2, 35°C x 48 hours|
If bone marrow received in blood culture bottle(s), process as a routine blood culture. Do NOT inoculate blood culture bottle(s) in the lab.
All isolates are to be identified.
Report the presence or absence of organisms.
Negative Report “No growth”
Positive Report Report all isolates with appropriate susceptibilities. Do not quantitate except if it is from the fluid medium only – add comment “From broth culture only, indicative of small numbers and/or contamination.”
Call all positive Gram stains and cultures to ward/ordering physician.
H.D. Izenberg. 2003. Blood Cultures-General Detection and Interpretation, p.184.108.40.206-220.127.116.11 In Clinical Microbiology Procedures Handbook, 2nd ed. Vol.1 ASM Press, Washington, D.C.