case_images: PMC10634493_01
case_images: An acid-fast bacillus (AFB; red arrow) found on direct examination using Ziehl-Neelsen staining (Magnification 1000x).
case_images: acmi-5-654.v3-g001.jpg
case_images: PMC10634493_01_acmi-5-654.v3-g001.jpg
case_images: F1
case_images: Mycobacterial testing was conducted on the lavage fluid and revealed acid-fast bacilli (AFB) on direct examination (Fig. 1) using the Ziehl-Neelsen staining method (1-10 AFB per 100 fields).
case_images: Axial ankle CT (a and b) scan showing diffuse infiltration of the soft tissues (red arrows) with significant gas extending from subcutaneous soft tissues and penetrating between bone structures (blue arrows). Note loss of cutaneous substance (white arrows).
case_images: acmi-5-654.v3-g002.jpg
case_images: PMC10634493_01_acmi-5-654.v3-g002.jpg
case_images: F2
case_images: Axial CT scan mediastinal (a, b and c) and lung (d) windows showing bilateral pleural effusion (blue arrows) which is more pronounced on the right side.
case_images: acmi-5-654.v3-g003.jpg
case_images: PMC10634493_01_acmi-5-654.v3-g003.jpg
case_images: F3
case_images: A thoracic CT scan, conducted at the request of the pulmonologist to investigate the extent of the disease, revealed a bilateral pleural effusion which was notably more pronounced on the right side (Fig. 3).