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Yuen and Tung describe a case of tuberculous osteomyelitis of the foot 1 and the potential difficulties in making the diagnosis. The authors were fortunate enough to have typical histological biopsy findings that subsequently cultured Mycobacterium tuberculosis (TB), providing diagnostic confirmation and estimations of sensitivities. However, in many instances, the diagnosis of tuberculosis is difficult to verify. For instance, acid fast bacilli may not be identified on biopsy or may be non-tuberculous in origin. Additionally, subsequent culture confirmation can take several weeks or may fail completely, because of the fastidious nature of TB.
Although the reliance on clinical suspicion is the basis for the diagnosis of many cases of TB, definitive confirmation is desirable in view of …
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