Morphology of the “Sulphur Granules” (Drusen) in Some Actinomycotic Infections. A Light and Electron Microscopic Study

The granules (Drusen) within the inflammatory lesions in three cases of infection by Actinomyeetales were studied with light and electron microscopy. The material consisted of subcutaneous granulomas caused by Actinomyces bovis in a cow, epidural granulomas caused by A. viscosus in the spinal canal of a cat and cerebral granulomas caused by Nocardia in a dog. The granules of A. bovis were 2000 to 3000 micrometers in diameter. Their centers consisted of a slightly basophilic, gram- and grocott-negative material with branching, gram-and grocott-positive filaments. The periphery was slightly basophilic or eosinophilic, but gram- and grocott-positive. Its surface was made of clubs (15 × 3.5 micrometers); they were acidophilic, gram- and grocott-negative. In the center of the granule there are numerous type a cells (coccobacillary cells with a trilaminar cell wall of 12 nanometers) and rarely type b cells (filaments with bilaminar cell wall of 30 nanometers). The periphery was made of germinative centers of type a cells. The clubs were lytic type b cells, embedded in an amorphous material. The granules (Drusen) of A. viscosus were 200 to 600 micrometers in diameter. Their center was slightly eosinophilic, gram- and grocott-negative and contained gram- and grocott-positive filaments. Their periphery was basophilic and contained alternating gram-and grocott-negative areas and radial gram- and grocott-positive filaments. There were no clubs. In the center there were type b cells (filaments with a trilaminar cellular wall of 30 nanometers). The periphery was made of germinative centers of type a cells (coccobacillary with a trilaminar cell wall of 10 to 11 nanometers). The germinative centers were separated from each other by radial bundles of type b cells. The granules (Drusen) of Nocardia were acidophilic, gram- and grocott-positive and surrounded by 1.8 × 0.5-micrometer clubs that were acidophilic, gram- and grocott-negative. There were type a cells (filamentous to bacillary with monolaminar cell wall of 19 nanometers and cross wall) and type b cells (filamentous to bacillary with monolaminar cell wall of 65 nanometers and without cross wall). The remarkable morphological differences of the three species of Actinomycetales are specific, independent from host and type of tissue, and therefore reliable for diagnostic purposes.