John W. Rippon

Disseminated trichosporon beigelii (cutaneum)

Two cases of invasive Trichosporon beigelii (syn. cutaneunt) infection are reported and are compared with the eight other previous reports. All affected patients were either immunosuppressed or had recently undergone a surgical procedure. The diagnosis had been delayed and the prognosis was poor. Only two patients recovered after vigorous antimycotic therapy and concomitant remission of their leukemia. A biopsy of the skin lesion, as illustrated in one of our patients, may prove to be useful in the early diagnosis.

Disseminated cutaneous and peritoneal hyalohyphomycosis caused by Fusarium species: Three cases and review of the literature

Three recent cases of hyalohyphomycosis caused by Fusarium sp. illustrate differing aspects of infections produced by these organisms. One patient was undergoing continuous ambulatory peritoneal dialysis when peritonitis developed caused by Fusarium moniliforme. Removal of the catheter and amphotericin B were used in successful management. In a neutropenic patient on therapy for leukemia, multiple persistent infections occurred including JK diptheroids, and Candida albicans sepsis. Finally, numerous florid skin lesions caused by Fusarium oxysporum developed even while the patient was receiving amphotericin B and he died. In a second neutropenic patient on treatment for leukemia, sinus and cutaneous lesions developed due to Fusarium. These resolved on amphotericin B therapy following the return of circulating neutrophils. The literature on Fusarium infections and aspects of the biology of the organism are reviewed.

Forty four years of dermatophytes in a Chicago clinic (1944–1988)

Data are presented on 39270 cultures taken over a 44 year span (1944–1988) at the University of Chicagos Dermatology Clinic. In the mid 1940s Microsporum audouinii accounted for 60–80% of isolates. It gradually decreased over the next two decades and disappeared altogether in the 1970s. Trichophyton rubrum, rare in the 1940s accounted for over 60% of isolates in the mid-1960s only to be overtaken by T. tonsurans. This species, not isolated till the mid 1950s, became and remains the dominant dermatophyte at the present time. Both T. mentagrophytes and Epidermophyton floccosum increased in the 1970s and decreased later. Unusual circumstances resulted in clusters of T. verrucosum, T. terrestre, and T. schoenleinii isolates. Infections were associated with rural dairy workers, zoo handlers and immigrant families respectively. M. canis and M. gypseum were steady at a low rate throughout the entire period. Rare isolates included M. cookei, M. persicolor, M. racemosum, T. simii, T. soudanense, T. violaceum, and the soil keratinophile, Aphanoascus fulvescens.

Elastase: Production by Ringworm Fungi

Isolants of nine species of Trichophyton, one of Epidermophyton, and four of Microsporum were assayed for elastase activity. The species or isolants with elastase activity were obtained from patients with inflammatory ring-worm infection. In Nannizzia fulva (M. fulvum), plus-mating-type strains were elastase-positive and minus-mating-type strains elastase-negative. A genetic study of mating type and elastase activity indicated a monogenic basis for both mating type and elastase activity.

Hendersonula toruloidea infection in man

Hendersonula toruloidea (HT) is a dematiaceous fungus that is an endemic human pathogen in tropical and subtropical countries. Infection with this fungus is often clinically indistinguishable from Trichophyton rubrum or other dermatophytoses. However, because HT will not grow on standard cycloheximide containing fungal media, and because HT is usually resistant to standard anti-fungal therapies, we believe that HT is a more common cause of ‘recalcitrant dermatophytosis’ in the United States than is currently recognized. HT may be especially prevalent among immigrant patients from endemic countries. We report the first cases of HT to occur in a non-endemic region of the United States. This suggests that HT may become a significant pathogen in the native American host as well. Moreover, we report the first case of a tinea capitis-like infection due to HT.

Aspergillosis: comparative virulence, metabolic rate, growth rate and ubiquinone content of soil and human isolates of Aspergillus terreus.

Significant differences were found between soil and human isolates of Aspergillus terreas in regard to virulence and in vitro growth rate. The growth rate on agar medium at 37° C was the same for all strains. At 25°C, however, the human isolate grew slower. In liquid media greater differences were noted. The soil isolates grew less well at 37°C (dry wt 0·54 g) than the human isolate (dry wt 0·97 g) in 3 days and had a lower metabolic rate QON2 45 compared to human isolate (QON 116). They had a higher final Eh of growth (Eh cal. 103) than the human isolate (Eh cal. 79). The ubiquinone content of the human isolate was 14 n moles/gm dry wt at 25°C and 172 at 37°C, whereas the soil isolates had values of 28–32 n mol/g dry wt an 25°C and 78–83 n moles/g dry wt at 37°C. An intravenous inoculum of 104 spores of the human isolate in mice was lethal, whereas 107 to 109 spores of the soil isolate were required for the same result.

Thermophillic and thermotolerant fungi isolated from the thermal effluent of nuclear power generating reactors: dispersal of human opportunistic and veterinary pathogenic fungi.

Over a period of a year, samples of water, foam, microbial mat, soil and air were obtained from areas associated with the cooling canal of a nuclear power station. The seventeen sample sites included water in the cooling canal that was thermally enriched and soil and water adjacent to, upstream, downstream and at a distance from the generator. Air samples were taken at the plant and at various disstances from the plant. Fifty-two species of thermotolerant and thermophilic fungi were isolated. Of these, eleven species are grouped as opportunistic Mucorales or opportunistic Aspergillus sp. One veterinary pathogen was also isolated (Dactylaria gallopava):The opportunistic/pathogenic fungi were found primarily in the intake bay, the discharge bay and the cooling canal. Smaller numbers were obtained at both upstream and downstream locations. Soil samples near the cooling canal reflected an enrichment of thermophilous organisms, the previously mentioned opportunistic Mucorales and Aspergillus spp. Their numbers were found to be greater than that usually encountered in a mesophilic environment. However, air and soil samples taken at various distances from the power station indicated no greater abundance of these thermophilous fungi than would be expected from a thermal enriched environment. Our results indicate that there was no significant dissemination of thermophilous fungi from the thermal enriched effluents to the adjacent environment. These findings are consistent with the results of other investigators.

Proteins and enzymes as taxonomic tools.

Publisher Summary According to the International Code of Nomenclature, organisms must be assigned to a species. When an organism is to be named, a dossier of its characteristics is prepared to determine whether the organism has already been described. If the organism does not fit into an already described species, it must be described to receive recognition as a “new” species according to the appropriate code. This ritual constitutes a memorial to Linnaeus who created order in the previously chaotic classification of plant and animal macroorganisms. In the beginning, microbial classification followed Linnaean protocol. Although considerable progress has been made in the preparation of increasingly more sophisticated dossiers, the microbial taxonomist seems to have produced increasingly greater Linnaean chaos in certain groups. Perhaps the situation is best appreciated by considering an opinion offered by a macrobial taxonomist. Whatever other functions may be attributed to taxonomy—such as investigating phylogeny, the creation of a data storage and retrieval agency is surely an inescapable one.

Isolation of Trichophyton soudanense in the United States

A case of tinea corporis, localized to the left side of the chin in a 68 year old Negro woman consistently yielded on culture the African dermatophyte Trichophyton soudanense. The patient is a native born U.S. citizen who has never been outside the country. This is the first recorded isolation of this organism in the United States.

Experimental mycosis in immunosuppressed rabbits. II. Acute and chronic aspergillosis.

The influence of immunosuppression on the course of experimental aspergillosis was investigated. Rabbits (2.2–2.5 kg) were divided into four groups. Group one received no drugs and was given 106 spores intravenously (IV) or intratracheally (IT) on two occasions one week apart. Weight gain or loss, appearance or disappearance of aspergillus antigen and/or antibody, and detection of aspergillosis at autopsy were followed. Group 2 received weekly injections of cyclophosphamide (70 mg/kg) starting two weeks prior and throughout the experiment. Animals in group three received either 1.14 or 2.25 mg/kg/day methyl prednisolone and group four received 2.28 mg/kg/ day methyl prednisolone and 70 mg/kg/week cyclophosphamide. In group one, serum antigen levels were detected within a week of infection followed by antibody (I.D.) levels for three months. All animals grew normally and no infection was detected at autopsy. In group 2, animals survived one but not two challenges and had Ag but no Ab. In group 3, animals survived two challenges at the lower drug level but not the higher. All animals in group 4 succumbed to one challenge.