Sparganosis, Henan Province, Central China

tant of the shell vial. No growth was obtained from the biopsy sample, but L. feelii was identifi ed similarly from colonies growing on buffered charcoal yeast extract agar plates injected with shell vial supernatant. The patient’s necrotic tissues were surgically excised; a vacuum-assisted closure system was used. Reexamination of the tissue biopsy samples ruled out the diagnosis of carcinoma. Finally, despite the fact that the shell vial technique requires specialized equipment and trained personnel, this method was performed in a reference center to improve the accuracy of a microbiologic diagnosis and, consequently, the care of the patient in uncommon situations (10). This improvement in diagnosis and care was also noted in an unusual L. pneumophila infection described by our team (2). In our laboratory, we have been performing the je ne sais pas protocol almost routinely since 1996 (10). Cell cultures provide supplemental tools to elucidate the cause of microbial diseases when results of PCR and classical agar procedures are negative. Furthermore, this procedure provides a means for the isolation of a wide range of intracellular bacteria, even when little biopsy material is available.