In four cases of carcinoma of the breast, variably acid-fast coccoid forms were found in sections from their metastases to the skin and in one of these cases in sections of the primary carcinoma. In this one case, similar-appearing corcoid forms were observed within the sections of the primary malignancy. In this same case, Staphylococcus epidermidis was cultured and studied at once and as it aged for development of forms comparable to those found in the microscopic sections of the neoplastic process. The implications of the findings for etiology of carcinoma of the breast are discussed.
The cutaneous lesions of seven consecutive patients with cutaneous lupus erythematosus (LE), two patients with systemic LE, and a patient with both dermatomyositis and cutaneous LE, were studied bacteriologically and microscopically for the presence of bacteria. The study was prompted by the previous reports of variably acid-fast and non-acid-fast bacteria in other collagen diseases, and also by recent reports confirming the presence of cell wall deficient (CWD) bacteria (staphylococci, streptococci, and corynebacteria) within the hematologic elements of both "normal" and diseased individuals. Staphylococcus epidermis was isolated from four cases. Propionibacterium acnes from two cases, and Corynebacterium sp. from one case. Three cases were bacteriologically negative. Basophilic- and eosinophilic-stained coccoid forms, suggestive of CWD bacteria, were identified in the microscopic sections of all the cases, as were non-acid-fast coccoid forms. Definite acid-fast coccoid forms were observed in vivo in two cases of cutaneous LE. The complex bacteriology of LE is discussed, as well as the possibility that variably acid-fast CWD microbes might be the long sought-after etiologic agent or agents in the production of LE.
Microscopic tissue sections stained for bacteria were studied from autopsy material from a fatal case of scleroderma (progressive systemic sclerosis). Extra- and intracellular, variable-sized, pleomorphic but predominantly coccoid bacteria were observed in some organs such as in heart, lungs, adrenals, kidneys, pancreas, skin, and in the connective tissue. An attempt is made to correlate the ante-mortem skin culture material with the post-mortem histopathologic finding of bacteria. It is hypothesized that these microbes observed in tissue might represent in vivo, cell wall deficient L forms, which may be implicated in the pathogenesis of scleroderma.
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