PMC9758986_01
(A) Diffuse low-density transparent areas can be seen in the lower part of the left femur and the upper part of the tibia. The boundary is unclear. The density of the patella is slightly uneven. The joint surface of the patella is narrow and rough, and the joint space is narrow. No abnormalities are found in the surrounding soft tissues. (B) Bone destruction is observed at up to a depth of approximately 2 cm inside the tibial tubercle, reaching deep into the medullary cavity.
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Continuous vacuum aspiration was performed to drain the wound (Figure 1).
Microscopic morphology (400 x) of L-form NTM. (red spheroids, arrows).
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Culture of the wound drainage fluid showed no growth of mycobacteria or other bacteria after 1 week, but a small number of red acid-fast positive spheroids were detected on smear microscopy (Figure 2).
Morphology of L-form NTM (blue arrows) on electron microscopy.
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Culture, microscopic examination, electron microscopy (Figure 3), polymerase chain reaction (PCR) assays and a reversion test (Figure 4) confirmed the presence of NTM and its L-forms.
Acid-fast bacilli, slightly curved, with a tendency to branch (arrows) are observed on microscopy after the reversion test.
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Culture, microscopic examination, electron microscopy (Figure 3), polymerase chain reaction (PCR) assays and a reversion test (Figure 4) confirmed the presence of NTM and its L-forms.