A Blind Smear From LJ Medium Revealing Pseudomonas aeruginosa Talus Osteomyelitis After Seeking for Osteotuberculosis in a 13-Year-old Teenager: A Case Report

Nasim  Eftekhari; Reza Rezaeizadeh; Shayan Shahabinejad

doi:10.18502/crcp.v5i4.5058

Nasim Eftekhari
Reza Rezaeizadeh
Shayan Shahabinejad

DOI: https://doi.org/10.18502/crcp.v5i4.5058

Keywords: Talus; Lowenstein Jensen (LJ); Pseudomonas; Osteomyelitis; Malachite green

Abstract

The Lowenstein-Jensen is an egg-based microbiology medium that was designed for selective isolation of Mycobacterium spp. The main inhibitory composition in this medium is a synthetic dye called malachite green. Mycobacterium spp. is resistant to the dye by de-colorization and oxidation of it. Some non-tuberculosis organisms may also overcome this inhibitory
ingredient by similar enzymatic activity. In the final inspection of the bone TB culture of a teenage patient, the blind smear revealed the Pseudomonas talus osteomyelitis. According
to the present and similar experiences, the preparation of 1-2 blind smears from TB culturenegative specimens taken from sterile sites of the body may unmask mycobacteria with the atypical colony and non-tuberculosis microorganisms.