Fig. 3 | Bone Research

Fig. 3

From: Evolving concepts in bone infection: redefining “biofilm”, “acute vs. chronic osteomyelitis”, “the immune proteome” and “local antibiotic therapy”

Fig. 3

The role of S. aureus intracellular infection as a virulence mechanism in chronic osteomyelitis. Extensive TEM analyses of S. aureus-infected human bone samples (n > X) failed to identify significant evidence of viable bone cells (osteoblasts, osteoclasts, osteocytes) containing intracellular bacteria, while all S. aureus colonized OLCN contain necrotic osteocytes (OC) with extracellular bacteria (red arrows) within osteocyte lacunae (a, TEM ×15 000). In contrast, an acridine orange-stained smears of blood, harvested post-mortem from a patient that died from septic multiorgan failure, demonstrates both extracellular bacteria (orange) and colonized leukocytes (yellow cells) via fluorescent microscopy (b, ×20). c A higher power fluorescent image of the blood smear reveals a “Trojan horse” macrophage with cytoplasmic S. aureus, and acentric nucleus (fluorescent green). d TEM (×20 000) of this Trojan horse macrophage was performed via a “pop-off” technique, which confirmed intracellular S. aureus cocci within the cytoplasm, adjacent to the nucleus (yellow arrow)

Back to article page