Some microbiologists feel that re- gional organizations compete with na- tional societies. Regional and national organizations serve different needs and therefore are not competitive. The ac-

tivities of the various societies comple- ment each other. Professional organi- zations have an obligation not only to fulfill the traditional role of dissemi- nating new knowledge, but also to

provide continuing education pro- grams. Any professional organization that fulfills the needs of its members is legitimate and deserves to be suc- cessful.

Case Report

Nocardiopsis dassonvillei Cellulitis of the Arm

Abraham Philip, M.S.* Manager, Section of Mycology MetPath, Inc. Teterboro, New Jersey O~d08

Glenn D. Roberts, Ph.D. Section of Clinical Microbiology Mayo Clinic Rochester, Minnesota 55905

A 7 l-year-old man had punctured his hand with a potato fork while gar- dening, with subsequent swelling and discoloration of the dorsum of his right arm. On his first outpatient visit he was treated with chloramphenicol. Six days later he was placed on oxacillin, but after two days he developed an ab- scess and was hospitalized.

The abscess was "drained and yielded copious thick yellow material. A Gram-stained smear of the drainage showed many neutrophils and a few gram-positive filamentous bacilli. The specimen was inoculated onto a variety of bacterial and fungal culture media. A portion of the excised tissue was stained by periodic acid-Schiff, acid- fast, and Gram stains, but no organ- isms were seen. Blood agar and Sa- bouraud's dextrose agar plates grew a pure culture of an organism, whose colonies were "dirty white" to light brown, dry, mealy, and had a distinct earthy odor. Gram stain examination of the organism revealed many beaded, gram-positive filaments and fragmented bacilli. The organism was partially acid-fast by the modified Kin-

* Present address: E. I. DuPont de Nemours & Co., Glasgow Research Laboratory, Wil- mington, Delaware 19898

youn stain. Biochemical and physio- logical test results included growth in 0.4% gelatin, failure to grow at 46°C., positive reactions for urease, casein hydrolysis, tyrosine decomposition and coagulation of litmus milk, and a weakly positive reaction for xanthine decomposition. Cell wall analysis re- vealed the presence of meso-diamino- pimelic acid. The organism was iden- tified as Nocardiopsis dassonvillei.

The patient was treated by surgical debridement followed by a skin graft on the dorsum of his right arm. He was discharged on oral trimethoprim- sulfamethoxazole, and made an excel- lent recovery within a few days.

Nocardiopsis dassonvillei belongs to the family Thermomonosporaceae of the order Actinomycetales, which also includes the genera Actinomadura, Dermatophihts, Mycobacterium, No- cardia, Rhodococcus, and Strepto- myces (2). The taxonomy of N. das- sonvillei has undergone several changes in recent years. The original strains of this organism were isolated by Brocq-Rousseu from mildewed grain and were described as Strep- tothrix dassonvillei (2). Several years later, Liegard and Landrieu recovered a strain from a case of ocular conjunc- tivitis that they concluded was iden- tical to the organism described by Brocq-Rousseu (8). Subsequently, Gordon and Horan reclassified this or- ganism as N. dassonvillei and found it to be very similar both macroscopi- cally and physiologically to Strepto- myces griseus (5).

The introduction of chemotaxonomic criteria, based on t.he stereoisomers of diaminopimelic acid (DAP) and var- ious diagnostically important carbohy- drates, has shed considerable light on the taxonomy and identification of

aerobic actinomycetes (1, 6). Leche- valier and Lechavelier (7) analyzed whole-cell hydrolysates for these diag- nostic markers and were able to note fundamental differences among the genera of Acthzomycetales. Their study resulted in the creation of a new genus Acthzomadura to accommodate the former Nocardia madurae, No- cardia pelletieri, and N. dassonvillei. More recently, Meyer (9) proposed a new genus name, Nocardiopsis, for Acthlomadura dassonvillei.

The extensive numerical analysis of nocardiform bacteria by Goodfellow supports the separation of Nocar- diopsis from Acthzomadura (3). More recently, immunodiffusion studies by Ridel (10) have shown marked differ- ences between Nocardiopsis and Acti- nomadura even though Acthwmadura, Nocardiopsis, and Nocardia asteroides share three common antigens. For these reasons Meyer's proposed genus, Nocardiopsis, for strains previously classified as A. dassonvillei seems ap- propriate at this time.

The partial acid fastness of our iso- late was confusing and may have been caused by staining of the conidia (4). Nocardiopsis dassonvitlei is a soil sap- rophyte. It has been isolated widely from soil and from animal infections (11). On occasion, however, it has been recovered from clinical material without associated clinical signifi- cance. In the compromised host, its role as a possible opportunistic invader should be considered. Our patient was infected by a potato fork, presumably contaminated with soil or plant mate- rial. It is noteworthy that at the time of the accident he was working around plants that were brought to the United States from Brazil by the previous owners of his mobile home.

14 0196-4399/84/50.00 + 02.00 Clinical Microbiology Newsletter

References 1. Becker, B. et al. 1964. Rapid differ-

entiation between Nocardia and Strep- tomyces by paper chromatography of whole-cell hydrolysates. Appl. Micro- biol. 12:421-423.

2. Brocq-Rousseu, D. 1904. Sur un Streptothrix. Rev. Gen. Bot. 16:219- 230.

3. Goodfellow, M., G. Alderson, and J. Lacey. 1979. Numerical taxonomy of Actinomadura and related organ- isms. J. Gen. Microbiol. 112:95-111.

4. Gordon, M. A. 1980. Aerobic patho- genic Actinomycetaceae. In E. H. Lennette et al. (eds.) Manual of clin- ical microbiology, American Society

of Clinical Microbiology, Washington, D.C.

5. Gordon, R. E., and A. E. lloran. 1968. Nocardia dassonvillei, a macro- scopic replica of Streptomyces griseus. J. Gen. Microbiol. 50:235-240.

6. Lechevalier, M. P. 1968. Identifica- tion of aerobic actinomycetes of clin- ical importance. J. Lab. Clin. Med. 71:934-944.

7. Lechevalier, H. A., and M. P. Leche- valier. 1970. A critical evaluation of the genera of aerobic actinomycetales. In H. Prauser (ed.), The Actinomyce- tales. VEB Gustav Fischer Verlag, Jena.

8. Liegard, II., and M. Landrleu.

1911. Un cas de mycose conjunctivale. Ann. Ocul. 146:418-426.

9. Meyer, J. 1976. Nocardiopsis, a new genus of the order Actinomycctales. Int. J. Syst. Bacteriol. 26:487-493.

10. Ridel, M. 1980. Immunodiffusional studies of some Nocardia species. J. Gen. Microbiol. 123:69-74.

I1. Rippon, J. W. 1974. Medical my- cology: the pathogenic fungi and pathogenic actinomycetes, W.B. Saun- ders Co. Philadelphia, PA.

12. Tisdall, P. A., and G. D. Roberts, 1979. Aerobic actinomycetes and the clinical microbiology laboratory. Clin. Microbiol. Newslet. 1(15): 1-3.

i

0196-4399/84/$0.00 + 02.00 © 1984 by Elsevier Science Publishing Co., Inc. 15