Case 164. Reference case 164B

　 　 　 　
　 Ziehl-Neelsen stain reveals numerous clumps of acid-fast bacilli among the subcutaneous fat cells. 　
　 　 　 　

　

 　 The acid-fast bacilli often form globular structures in the necrotic tissue. They are extracellular in location. The disease is seen mainly in the central and west Africa.