The case of the disappearing mycobacteria in Ziehl-Neelsen-stained smears

摘要

A student from Guinea-Bissau presented with a 2-year history of painful swollen lymph nodes in the right side of her neck. Some had opened and formed fistulas that suppurated (Figure 1A). Smears of pus were stained with auramine O (AuO) and screened for mycobacteria at 200× magnification. Very rare images with the morphology of acid-fast organisms were seen in two samples. Following current recommendations, the AuO-stained smears were restained with Ziehl–Neelsen (ZN) to confirm the findings of these images.