Bone marrow changes in human malaria: a retrospective study.
The bone marrow reports of 1966 patients admitted to a provincial teaching hospital between January, 1992 to April, 1995 were retrospectively analyzed. Twenty-six (1.3%) bone marrows showed the presence of malarial parasites. Sixteen (62%) patients had Plasmodium falciparum 9 (34%) Vivax malaria and one (4%) mixed infection. All these patients gave a history of prolonged illness and had low parasite counts. Plasmodium vivax malaria was not associated with any significant pathology in the bone marrow, except iron deficiency anaemia. The bone marrows with Plasmodium falciparum malaria showed myeloid hyperplasia, erythroid hyperplasia, megaloblastosis and hypoplasia in different proportions. No evidence of dyserythropoiesis was found in this series. The possible mechanisms producing these changes and the factors responsible for the discrepancy in bone marrow findings in different geographical areas are discussed.