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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?

To find out, we access the Microbiology module and select the appropriate culture results in the Phenotypic Tests window:

Based on the phenotypic tests entered, GIDEON displays identification results in the Identification List window:

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 the button.

As we see in the next screen, GIDEON recommends that we examine Acetate utilization, Esculin hydrolysis, and Catalase (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: