David T. Smith

Miscellaneous fungus diseases

Abstract A brief review of sporotrichosis, geotrichosis, aspergillosis, penicilliosis, mucormycosis, chromoblastomycosis, maduromycosis, and rhinosporidiosis will be presented in this article. Sporotrichosis ranks with the major fungus infections of man and deserves, if space permitted, a more comprehensive presentation. The other mycoses listed above are not of major importance in this country.

Gross Reactions with Tuberculins on Guinea Pigs with Single and Double Experimental Infections with Mycobacteria.

Summary Primary sensitization of guinea pigs with Battey, fortuitum, human, photochromogen, and scotochromogen mycobacteria produced large tuberculin reactions to the homologous PPDs but less and varying degrees of cross reactivity with other PPDs. Double infections in guinea pigs from human and scotochoromogen bacilli gave large cross reactions with PPD-A and PPD-B, but not with PPD-Y or PPD-F. Double infections with human and photochromogen bacilli gave large reactions to PPD-S and PPD-Y but not to PPD-B or PPD-F. Double infections with Battey and human bacilli gave large cross reactions to PPD-scot. but not to PPD-Y or PPD-F. It is concluded from these observations that skin testing with a battery of PPDs at the 5 TU dose level may be a valuable diagnostic tool in the presence of infection by a single organism. This value decreases in the presence of a double infection.

An epidemic of histoplasmosis in Warrenton, North Carolina.

The description of an epidemic of histoplasmosis in a nonendemic area should remind us of this disease in differential diagnosis under certain circumstances.

Experimental Production of Cervical Cellulitis Resembling Ludwig's Angina.

Infections in the floor of the mouth may extend into the deep facial planes of the neck and produce a cellulitis which has a decided tendency to terminate in gangrene or abscess formation. Ludwig originally described the condition as a gangrenous induration of the neck; Vincent refers to the disease as a foetid para-buccal abscess. The primary focus occurs about the teeth in most instances (Muckleston, 1 Van Wagenen and Costello, 2 Ashhurst 3 ). These observers, among others recovered an aerobic streptococcus from the cervical lesion, more rarely staphylococci or other aerobic organisms, which they regarded as presumably the causal agent. However, no reference is made to anaerobic studies. Melchoir 4 found fusiform bacilli and cocci in 4 cases; fusiform bacilli alone in one case; spirochetes, fusiform bacilli and cocci in another case. More recently, Hansen∗ told me he observed a fatal case of Ludwigs angina in which he found fusiform bacilli and spirochetes in large numbers. It has been demonstrated that local lesions about the teeth generally harbor fuso-spirochetal organisms. These organisms produce a foul abscess or gangrene when introduced into the tissues of animals. 5 , 6 , 7 It therefore seemed reasonable to infer that Ludwigs angina might be due to a fuso-spirochetal infection. The scrapings from the teeth of patients with pyorrhea were inoculated into the inner margin of the gum of the lower posterior teeth in 25 guinea pigs. Each of 5 pigs received 0.25 cc. of pyorrhea material. Four animals remained normal, the fifth, after 5 days, developed an enlarged gland deep in the neck immediately below the mandible. The gland gradually enlarged during the following week and the infection spread to the surrounding cellular tissue.

Filter-passing bacteria in the nasal passages of animals.

Anaerobic cultures of the filtered nasopharyngeal secretions from man reveal a varied bacterial flora. There have thus far been described, Bacterium pneumosintes, 1 obtained from fresh cases of typical epidemic influenza, and three distinct groups 2 of Gram-negative, filterable, anaerobes, derived from patients with influenza, obscure upper respiratory affections, or common colds, as well as from persons supposedly healthy. To the latter three groups may be added another related species which will be described later and which has been isolated from a number of cases of infectious common cold. The object of the present study was to determine whether, and to what extent, this class of microorganisms is distributed among laboratory animals. Accordingly, the filtered materials obtained from the nasal mucosa of 10 monkeys, 7 horses, 17 dogs, 5 cats, 20 rabbits, 20 guinea pigs, and 20 rats were cultured by the same methods which had yielded growth of the different species of bacteria from human secretions. Suspensions in one per cent dextrose Ringers solution were prepared of the nasal mucosa, dissected or curetted away from the underlying bone of recently killed animals, or of the nasal secretions collected on cotton swabs of living ones. The suspensions were filtered through Berkefeld “V” candles, impervious to Pfeiffers bacilli or Bacillus prodigiosus, at 650 mm. Hg negative pressure. The culture media 2 used were the Smith-Noguchi fluid medium and rabbit blood agar plates, and the cultures were incubated for 7 days under anaerobic conditions in Browns jara modification of the McIntosh and Fildes apparatus. In no instance, thus far, have any filter-passing microorganisms been cultivated from this material by the methods employed. 3