In Reply.—We appreciate Dr Threlkeld's comments regarding our article.1 He clearly agrees with the main conclusion of our study regarding the benefits of early liver biopsy in human immunodeficiency virus—infected patients with fever of undetermined origin. In turn, we agree with him that there may be some geographic variation in the opportunistic infections responsible for the fever. Certainly, in New York City, where our study was performed, hepatic granulomata in these patients are most frequently associated with mycobacterial infection. Nevertheless, in other parts of the world, hepatic granulomata may be associated with other pathogens. Consequently, it is important to perform special stains on histological specimens, and to follow up the cultures of tissue biopsy specimens for more precise diagnosis.
PREGO V, RAUFMAN J. Comparative Yield of Blood Culture for Fungi and Mycobacteria. Arch Intern Med. 1990;150(10):2204. doi:10.1001/archinte.1990.00390210150033