372 ACTINOMYCOSIS 



Other clinical types of actinomycosis are caused by distantly re- 

 lated, or perhaps unrelated, actinomycetes (Nocardia spp.) . One type 

 of Madura foot, for example, is caused by Nocardia madurae, and 

 this disease has been known since Carter's studies in 1861. A general- 

 ized actinomycosis, usually involving the central nervous system and 

 caused by an acidfast actinomycete {N. asteroides) also has a history 

 somewhat confused and obscured by the lapse of time and the muta- 

 bility of the fungus causing it. A^. asteroides was isolated by Eppin- 

 ger from a brain lesion in 1890. In addition to these better known 

 species there are several others and some named varieties which will 

 be discussed later. Other types of infection with some clinical and 

 histological resemblance to actinomycosis have sometimes been con- 

 fused with it. Actinobacillosis ^* and Staphylococcic actinophytosis 

 (botryomycosis) '^ are the most important of these. 



For the reasons just given the name actinomycosis as sometimes 

 used in the broad sense is almost meaningless. Even when it is used 

 in a restricted sense to include only those diseases caused by actino- 

 mycetes it is still indefinite because of the multiplicity of species and 

 of the types of disease which they cause. Strictly speaking actino- 

 mycosis should refer only to the disease which is caused by the anae- 

 robe, A. bovis, and in which sulphur granules are characteristically, 

 but not invariably, present. A mycosis caused by a species of No- 

 cardia (aerobic and in some cases acidfast actinomycetes) would 

 , then, in the narrow sense, be called nocardiosis. 



Actinomycosis in Lower Animals. Actinomycosis occurs in a va- 

 riety of animals, both wild and domesticated. Moody has described 

 lesions, clearly actinomycotic, in the bones of a fossil rhinoceros. 

 The disease is known to occur in deer and moose, sometimes in epi- 

 zootic form. It has been noted in practically all the domesticated 

 animals, but mainly in the herbivorous species, and particularly in 

 cattle. The disease in cattle occurs in all parts of the world, but is 

 more frequent in certain areas. Thus in the United States more 

 cases are observed in the slaughter houses of the Middle West than 

 in the eastern or southern states. This apparent difference may be 

 due to a more systematic search for the disease in some areas, how- 

 ever. It is annually a cause of considerable economic loss. 



The disease is probably transmitted from animal to animal in- 

 directly through contact wdth fodder contaminated by the infected 

 animal. A number of authors have reported the presence of particles 

 of hay or grain, especially the awns of barley, covered with a growth 

 of Actinomyces, in the tonsils, the soft tissues about the teeth, or in 

 the tongue of cattle and swine. It is probable that in such cases the 



