*HUMAN BOTRYOMYCOSIS 

 BY 



Captain R. G. Archibald, M.B., R.A.M.G., attached E.A. 



Pathologist aud Assistant Bacteriologist 

 Wellcome Tropical Research Laboratories, Khartoum 



Within the past year opportunities occurred of studying a peculiar patliological 

 condition in certain tumours which liad been sent to the Wellcome Tropical Eesearch 

 Laboratories from various parts of the Sudan. The first of these was a tumour removed 

 from the scalp of a native. Stained sections made from this specimen showed the 

 presence of agglomerations or collections of circular disc-like masses lying irregularly 

 throughout the tumour mass. When stained by the aniline dyes they exhibited a 

 homogeneous appearance without any ajDparent intrinsic structure, and closely resembled 

 collections of staphylococci of varying sizes. Similar appearances had been previously 

 observed by Dr. Balfour in a growth removed from a camel, and had been recognised 

 by him to be botryomycotic in nature. 



After reference to all the available literature had been made, the conclusion arrived at 

 was that these collections of coccus-like masses also represented a pathological entity met 

 with in a somewhat rare disease named botryomycosis, and, in fact, were pathognomonic 

 of it, the disease itself deriving the name of botryomycosis from the resemblance 

 these collections of coccal masses bear to a cluster of grapes. Since this first case no 

 less than seven other tumours, removed from the breast, arm, hand, foot and scrotum, Association 

 have been found to contain similar coccus-like agglomerations. Three of these tumours w''h strepto- 

 had, in addition, all the pathological macroscopical appearances associated with ^^^^ 

 Streptothrix madurm and its presence was subsequently confirmed microscopically. In 

 the others there was no evidence of a streptothrix existing, although a careful search 

 was made through a large number of sections taken from various parts of the growths. 



It may be stated that one was somewhat diffident in naming the condition botryomy- 

 cosis but for the fact that the pathology of these growths closely simulated the description 

 given of this disease by Ernst^ and other observers, who found these collections of coccus- 

 like masses present in certain lesions in animals, notably the horse, cow and hog, and 

 who, for some time, described them as staphylococcal in character. This staphylococcal 

 view, however, is no longer tenable, for special staining reactions have shown them to be of 

 a different nature. Cultural and inoculation experiments would doubtless assist in clearing 

 up the exact nature of these bodies, but, unfortunately, opportunities of examining fresh 

 pathological material have not occurred, and, as a result, the work embodied in this paper 

 is somewhat incomplete. Kitt,- in his text-book on comparative pathology, defines 

 botryomycosis as a productive inflammation leading to the formation of fibrous growths 

 attended invariably with suppuration and fistula formation, or the production of 

 yellowish-red foci of softening caused by infection with the Botryomyces ascoforinans. 



* Reprinted from the British Medical Journal, October 1, 1910, being a jiaper read before the British 

 Medical Association, 1910. 



' Ernst, W. (1908), "Die Enstehung der Botryouiycosraseu aus der Stai^hvlokkon form des Erregers." 

 Ucntralbl. f. Bnkl., 1 Abt. Origiuale, Vol. XLV., No. 2. 



- Kitt, Th. (1906), "Botryomycosis." Comparative General Patholoyij. 



