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Case Reports in Infectious Diseases
Volume 2015, Article ID 628028, 6 pages
Case Report

Bone Marrow Granuloma in Typhoid Fever: A Morphological Approach and Literature Review

1Department of Pathology, Pondicherry Institute of Medical Sciences, Puducherry 605014, India
2Department of General Medicine, Pondicherry Institute of Medical Sciences, Puducherry 605014, India
3Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry 605014, India

Received 30 October 2014; Accepted 10 February 2015

Academic Editor: Larry M. Bush

Copyright © 2015 Kavitha Muniraj et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Typhoid fever is one of the few bacterial infections in humans where bone marrow evaluation is routinely recommended. However, the morphological aspect of typhoid fever in bone marrow has been rarely described in the literature. We describe a 25-year-old male patient who presented with prolonged fever suspected to be of tubercular etiology. Bone marrow examination showed well-formed histiocytic and epithelioid granulomas and erythrophagocytosis; and the bone marrow aspirate culture grew Salmonella typhi A. In view of potential clinical implications, typhoid fever should be considered as a differential diagnosis to tuberculosis in the evaluation of prolonged fever; especially in high prevalent areas. We suggest that erythrophagocytosis may serve as a morphological marker in typhoid granulomas in the bone marrow; and bone marrow culture should be submitted in every suspected case for appropriate patient management.