Bone marrow cryptococcal infection in the acquired immunodeficiency syndrome

Objectives: To describe the bone marrow lesions in eight cases of Cryptococ cus neoformans infection involving the bone marrow in HIV-infected patients , Methods: Archival bone marrow biopsies from patients with HIV-related crypt ococcosis of the bone marrow were retrospectively reviewed. Cryptocococcal organisms were identified on haematoxylin- and eosin-stained slides and con firmed using mucicarmine staining. Results: Yeast cells stimulated a granulomatous response in all cases despi te immunosuppression. The number of cryptococcal organisms appeared to be i nversely proportional to the adequacy of the granulomatous response. AIL pa tients had a cytopenia, Conclusions: The ability to mount a tissue response in order to localize or ganisms is retained in patients with AIDS. Infection of the bone marrow wit h cryptococci may act in synergy with HIV to cause cytopenia. (C) 2000 The British Infection Society.