2003
DOI: 10.1086/378563
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Cell‐Wall Alterations as an Attribute ofMycobacterium tuberculosisin Latent Infection

Abstract: Ziehl-Neelsen (ZN) staining is the key technique for diagnosis of mycobacterial infections; however, a high percentage of patients exhibit positive signs of tuberculosis, as indicated by pathology, culture of mycobacteria, and polymerase chain-reaction analysis, and yet show negative results on ZN staining. In this report we present evidence that such ZN-negative specimens represent Mycobacterium tuberculosis bacilli in a dormant state with distinct cell-wall alterations: the classical cell-wall composition-de… Show more

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Cited by 144 publications
(136 citation statements)
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“…Indeed, the low number of AFB observed in focal granulomas by ZN staining was already pointed out by Balseiro et al (2003) and González et al (2005), and it seems to be more related to the difficulties to stain dormant MAP whose cell wall has lost acid-fastness than to absence of this agent in the macrophagic cells (Seiler et al, 2003).…”
Section: Discussionmentioning
confidence: 85%
“…Indeed, the low number of AFB observed in focal granulomas by ZN staining was already pointed out by Balseiro et al (2003) and González et al (2005), and it seems to be more related to the difficulties to stain dormant MAP whose cell wall has lost acid-fastness than to absence of this agent in the macrophagic cells (Seiler et al, 2003).…”
Section: Discussionmentioning
confidence: 85%
“…Sometimes, persistent M. tuberculosis bacteria bearing cell wall alterations may remain undetected by the classic Ziehl-Neelsen staining (Seiler et al, 2003). Appearance of polymorphic non-acid fast forms and coccoids in cultures of mycobacteria has been observed by other authors (Chandrasekhar & Ratnam , 1992;Csillag, 1964;Juhasz, 1962;Miller, 1932;Xalabarder, 1958).…”
Section: L-conversion Morphology and Ultrastructurementioning
confidence: 83%
“…Ziehl-Neelsennegative bacilli can be detected in chronically infected mice as well as in non-progressive human tuberculous lung lesions [50]. In contrast, M. tuberculosis present in cavernous cavities with access to the bronchial system and thus to an ample oxygen supply, appear ZN-positive, are coughed up, and are stained in sputum of patients with active TB.…”
Section: Transition Of M Tuberculosis Into a Dormant State Within Grmentioning
confidence: 99%