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Fig. 4 | BMC Infectious Diseases

Fig. 4

From: Infectious agents is a risk factor for myxomatous mitral valve degeneration: A case control study

Fig. 4

Bacterial analysis by IHC, ISH and TEM. a: Counts of Mycoplasma pneumoniae (Mp), Chlamydophila pneumoniae (Cp) and Borrelia burgdorferi (Bb) antigens. b, d, f, h, j and l: Normal mitral valve. c, e, g, i, k and m: Mitral valve with myxomatous degeneration; b and c: IHC for Mp; d and e: Mp antigen identification (yellow dots) by Aperio analysis; f and g: IHC for Cp; h and i: Cp antigen identification (yellow dots) by Aperio analysis; j and k: IHC for Bb; l and m: Bp antigen identification (yellow dots) by Aperio analysis. n, o, p and q: Transmission electron microscopy of bacterial elements (arrows). N: A microorganism with Mycoplasma characteristics was identified in the control group, with a long, single envelope membrane and a structure similar to a spirochete in the cytoplasm amid fragmented collagen tissue. O: This structure is consistent with Borrelia, long and winding, and was identified in the control group. P: Structures compatible with Mycoplasma were also identified in the MD group. Q: A microorganism with a wavy structure compatible with spirochete-containing organelles or endosymbionts (consistent with Borrelia) was observed in the MD group. IHC: immunohistochemistry; ISH: in situ hybridization; TEM: transmission electron microscopy; Mp: Mycoplasma pneumoniae; Bb: Borrelia burgdorferi; G1: group 1; G2: group 2; μm2: square micrometers; Ag: antigen; mm: millimeters. Bar =50 μm for B-M. Bar =1 μm for N-Q

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