BOTRYOMYCOSIS 



2255 



Historical and Geographical Distribution. — The condition was 

 first studied in horses, in which it occurs often in the testicular 

 cord after castration; but it is common also in the pig, dog, and 

 cattle. Later it was found in man by Dor and Poncet in Europe. 

 In the tropics it has been observed in Ceylon by one of us. 



etiology. — The condition is believed by some observers to be due 

 to an organism [Botryococcus ascoformans Kitt, Micrococcus hotryo- 

 genes Rabe), the botanical position of which is not defined. The 

 organism appears in the lesions under the form of spherical bodies 

 of very different size (o-8 to 12 /a), singty or collected in clumps, 

 Gram- positive, and to a certain extent acid-fast. They seem to 

 reproduce by a process of endosporulation. The cultures obtained 

 by some authors have, however, all the characters of a staphylo- 

 coccus. 



Some authorities, in fact, consider the disease to be merely a 

 type of pyosis due to the usual staphylococci. Magrou, using a 

 special technique, has succeeded in experimentally reproducing the 

 disease by inoculating a strain of Staphylococcus aureus isolated 

 from an ordinary case of sepsis. M. Nicolle and Cesari have shown 

 that the serum derived from horses affected with botryomycosis 

 neutralizes staphylococcal toxins. Letulle considers the disease 

 to be due to an amoeba, and his results have been confirmed by 

 Bureau and Labbe, but not by others. 



Pathology. — The condition, as seen by us in the tropics, has all 

 the characters of a granuloma. The microscopical examination of 

 sections shows young connective tissue with large numbers of 

 plasma cells. Peculiar claviform bodies have been described by 

 Magrou, who believes them to originate from the staphylococci. 

 The lesions are very vascular. Later, denser fibrous tissue is 

 observed. 



Symptomatology.' — The condition generally develops on some 

 suppurating wound, but may occur upon the site of any abrasion 

 or wound. It appears as a small, generally cherry-red, granu- 

 lomatous nodule or mass, often roundish, of various size — from 

 a pea to a nut or larger. Occasionally the nodule may be pedicu- 

 lated. At first it is of rather soft elastic consistency; later may 

 become fibrous and much harder. There is very little tendency to 

 spontaneous cure. A very mild type of botryomycosis occasion- 

 ally develops after vaccination. We have seen several such cases. 



Prognosis. — The general health is not much affected, but the 

 condition has little or no tendency to spontaneous cure. 



Treatment. — Excision, followed by light cauterization with pure 

 carbolic or chloride of zinc, is the only method of treatment. The 

 pedunculated form may be cured by ligature. The disease may 

 occur again after operation, but this is rare. 



Prophylaxis. — Care should be taken to keep suppurating wounds 

 thoroughly disinfected. 



