The past two decades have witnessed many instructive revelations of the anatomy and biochemistry of the bacterial cell.1,2 These discoveries have stimulated great interest in the possible role, in clinical or experimental infection, of bacteria which differ from conventional bacterial forms.3-5 Are such organisms laboratory freaks or do they play a role in disease?
The terminology of bacteria wholly or partly deficient in their cell walls has become increasingly confused and is still subject to nuances of interpretation. The term L-form was coined in 1935 by Emmy Klieneberger, MD,6 to designate what she called "protoplasmic forms" derived from a strain of Streptobacillus moniliformis with which she was working at the Lister Institute in London. Not knowing exactly what she was dealing with, but needing a name, she called these aberrant organisms "L-forms," after the Lister Institute. Subsequent studies by microbiologists have resulted in the usual spate of