Case of the Month
“Creative DeBugging”
Exploration of GIDEON’s Microbiology Module
A 47 year old man is found to have a large abscess in his left leg. Routine cultures reveal a branched, aerobic, non-sporulating, Gram-positive bacillus. What micro-organisms should be considered ? What procedure should the laboratory perform at this point ?
Phenotypic tests were entered into the Microbiology module of GIDEON:
The organism in question appears to be one of several species of Nocardia. In order to determine the most discriminative laboratory test to perform at this point, we will check all of the organisms, and press ‘Compare’. As we see in the next screen, GIDEON recommends that we examine Citrate, myo-Inositol and Mannitol [top three tests].
Our organism was ‘positive’ for all three additional tests. After re-identifying the organism we can see in the following screen that the most likely identification in this case is Nocardia brasiliensis.
Additional clinical and bacteriological hints are displayed when we click on the organism name:
