PMC3326967_01
X-rays of the patient at presentation, showing grossly normal bony architecture
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F1
X-rays of the right femur revealed grossly normal bony architecture but altered soft tissue shadows in the surrounding thigh musculature [Figure 1].
MRI of lower end of femur suggestive of acute osteomyelitis with large collection of abscess in deep posterolateral aspect of thigh along with infiltration of adjacent muscles
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F2
This was followed by an MRI [Figure 2] that was done 2 weeks later which highlighted signs of acute osteomyelitis of lower end of femur with large collection of abscess in deep posterolateral aspect of thigh along with infiltration of adjacent muscles.
Histological profile. (a) The microphotograph showing a fibrocollagenous tissue with extensive small blood vessel and capillary dilatation as well as congestion. The dilated capillaries are heavily surrounded by dense polymorphonuclear cells and debris. The overall picture is of a granulation tissue. Very occasional eosinophils are also seen. (b) One of the portions of the same tissue showing predominantly a lymphomononuclear inflammation admixed with some polymorphs and debris. The inflammatory foci are also infiltrated by adipose cells. (c) Other focuses showing a mixed inflammatory infiltrate with few congested capillaries. The inflammatory cells are composed of neutrophils and lymphomononuclear cells in a background of hemorrhage
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F3
Histopathologic examination of muscle biopsy revealed parasitic infection with esosinophilic infiltrates, and a possibility of parasitic cyst was kept on the basis of histological findings [Figures 3a-c].