staining Techniques LA Acid-Fast stain (ziehl-Neelsen and Kinyoun Methods CASE F
ID: 91621 • Letter: S
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staining Techniques LA Acid-Fast stain (ziehl-Neelsen and Kinyoun Methods CASE FILE A 60-year-old male dairy farmer (Patient visited his primary care physician complaining of knee and hip pain. months earlier, the farmer had bruised his knee while moving hay bales. The bruising had been minor, and only in the last 3 weeks did he report experiencing joint pain and feeling ill. The patient also stated he had been losing weight, coughing. and feeling more fatigued than normal. The farmer lived alone and had not had any long-term sustained contact with anyone else. The doctor noted the knee joint was slightly swollen, but no other signs of inflammation were observed. Mobility in the joint appeared limited. The patient's lungs sounded congested. The doctor suspected the patient had tuberculous arthritis. The doctor ordered blood work, acid-fast staining of a sputum sample, a Mantoux tuberculin skin test, and a chest X ray. He asked the patient to return in 2 days. The patient's CBC (complete blood count) indicated an elevated monocyte count. The chest X ray showed several areas of patchy infiltrate with hazy borders. A 10-millimeter wide area of induration (hardened, raised, and palpable) was present on the forearm where the Mantoux tuberculin skin test was done, indicating an active recent mycobacterial infection. Acid-fast staining of his sputum revealed the presence of slender, acid-fast positive bacilli. The patient was prescribed a 2-month regimen of isoniazid, rifampin, and pyrazinamide. This was followed by the prescription of resolved at completion of this course of treatment. The patient did not experience any long-term ill effects or joint damage LEARNING OUTCOMES At the completion of this exercise, students should be able to list the common genera of acid-fast bacteria and the clini- cally significant diseases they cause. stain. S?rrectly perform and interpret an acid-fast technique ing 12Explanation / Answer
4) Since Mycobacterium tuberculosis is a latent infection that persists in the lymphoid tissues for a long time, the treatment requires longer duration. Non compliance of tuberculosis treatment regimen results in
5) Inflammation of knee joints with limited movements, presence of fever, weight loss, coughing, fatigue and congested lungs made the physician to think that the patient might have tubercular arthritis.
6) If all of the organisms are stained blue in AFB staining, over washing with acid alcohol could have occurred which removed all of the primary stain and the organism take up the color of secondary strain, methylene blue.
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