case_images: PMC3929008_01
case_images: Discharging sinus of chronic osteomyelitis
case_images: ABR-3-32-g001.jpg
case_images: PMC3929008_01_ABR-3-32-g001.jpg
case_images: F1
case_images: The patients was initially fine for two weeks after that he suffered from persistent pain over affected region and six months later a sinus tract developed along with purulent discharge. [Figure 1] The patient received various combinations of antimicrobials (mainly second and third generation cephalosporins) to control the disease.
case_images: Blood agar plate showing (a) small colony variant (b) normal variant of Staphylococcus aureus
case_images: ABR-3-32-g002.jpg
case_images: PMC3929008_01_ABR-3-32-g002.jpg
case_images: F2
case_images: After 48 hours of incubation non-pigmented small 0.1 mm diameter non haemolytic colonies grew on BA plate. [Figure 2] MA plate showed no growth. Subculture from this large colony revealed yellow pigmented normal Staphylococcal colony. [Figure 2b] These large colonies were catalase, coagulase (slide and tube) tests positive and oxidase negative.
case_images: Antibiotic susceptibility test result of small colony variant of S. aureus
case_images: ABR-3-32-g003.jpg
case_images: PMC3929008_01_ABR-3-32-g003.jpg
case_images: F3
case_images: Antibiotic susceptibility test result showed the isolated strain was only susceptible to vancomycin and resistant to oxacillin, azithromycin, co-trimoxazole, and cefpodoxime. [Figure 3] A lawn culture was put on NA plate along with 20 ug and 40 ug menadione impregnated discs over it.