Development of Highly Organized Lymphoid Structures in Buruli Ulcer Lesions after Treatment with Rifampicin and Streptomycin
Figure 5
Bacterial load and distribution in four patients.
Histological sections representative for four patients stained with ZN (A to D) and polyclonal anti-leprae antibody (pAbLep; E to G) to demonstrate distribution of mycobacterial material in the excised lesion. Counterstain was performed with haematoxylin and pictures taken at magnifications of ×100 (A, E), ×200 (G), ×400 (B, F) and ×1000 (C, D). (A, E) Serial sections demonstrate equal detection sensitivity with ZN and pAbLep. Higher amounts of bacterial material near the ulcerative edges with macrophages being the most prevalent leucocytes. (B, F) Close-up of A and E, respectively. Foci of rounded bacteria located extra- and intracellular between fat ghosts. (C) Macrophage presenting with mycobacterial material within phagosomal vesicles. (D) Mycobacterial residues appear in rare cases inside Langhans' giant cell phagosomal vacuoles. (G) Small granuloma with giant cell formation and traces of mycobacteria inside a phagosome.