THE PATHOGENIC HIGHER BACTERIA 
009 
nitely kno^A^l if all chronic cases prove fatal or if some eventiially 
recover. The Xocardia appear to be widely distributed in the soil, 
water, upon foodstuffs and upon plants and it is suggestive that nearly 
50 per cent of all cases reported have been infections of the head and 
neck.^ About 20 per cent of cases are chest infections and the clinical 
symptoms are very like those of tuberculosis. If repeated sputum 
examinations are negative although the syndrome suggests tuberculosis, 
search should be made for Xocardia. 
Morphology.— The Nocardia are very pleomorphic; in purulent 
material and other discharges the organisms are of varying length; 
some short and rod-shaped, others long-branched filaments (myceUa). 
The filaments usually segment or fragment, producing the shorter 
bacillary forms and, in artificial media, forming chains of spores as 
well. Old cultures in artificial media are composed chiefly of bacilloid 
forms— long, somewhat curved filaments which may or may not be 
branched, and spores which occur singly or in small groups and pairs. 
The organisms may or may not be acid-fast, but they are Gram- 
positive. The granules or "driisen" so characteristic of actinomycotic 
infections are not foimd in Xocardial mvcoses. 
Fig. S5.— Streplotliiix from \\ 
ibscess. Blood agar culture. 
Cultivation. — Xocardia may frequently be grown upon artificial 
media— gelatin or agar— directly from pus or other morbid material. 
The colonies develop slowly and after five to seven days they appear 
as gray, opaque, shining plaques which may reach 3 to 5 mm. in 
1 Clayuolc: Jour. Am. Med. Assn., 1914, 63. 604. 
39 
