Dear colleagues
I found a trypomastigote of Trypanosoma cruzi in the bone marrow aspirate from a patient. Although the sample is very characteristic of marrow, I'm afraid that may have occurred some contamination with peripheral blood. It is possible that this finding is truthful?
I think this finding is significant and should be taken seriously. The level of parasitemia in the blood of patients infected with T. cruzi is relatively low, so the likelihood of finding it as a contaminant in a BM aspirate is low. In addition, it would not be beyond reason to find tryps in the bone marrow of a patient with parasitemia. Clinically, it is a diagnostic finding. If the patient was already known to have parasitemia and now you find it in the bone marrow it doesn't change the need for therapy. What is the story on the patient? Symptoms? Risk factors? Why did you get a BM aspirate? Anemia? Pancytopenia?
Trypanosoma spp. can occur in bone marrow. I found Trypanosoma spp. (probably rhodensis) in bone marrow of a patient in the early 80-ies in the Okvango delta of Botswana.
There are some finds of bone marrow parasitism in both infected patients and in experimental infection. You can see them in:
http://www.ncbi.nlm.nih.gov/pubmed/96243
http://www.ncbi.nlm.nih.gov/pubmed/22329435
Thank you all for the answers.
The patient has HIV and seems to have undergone a reactivation of a latent Chagas disease. The therapy has already started.
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