Morris A. Gordon

Detection of Cryptococcus neoformans antigen in body fluids by latex particle agglutination.

Summary Antigen of C. neoformans was detected in serum and/or CSF from 7 of 9 cases of CNS cryptococcosis by a rapid, sensitive slide test in which antibody-coated latex particles are agglutinated. The procedure yielded few nonspecific reactions, which were of low degree. Decline in reactivity following treatment suggests that the test has prognostic as well as diagnostic value. Lack of reactivity of blood and CSF from 2 patients was shown not to be attributable to serotype variation.

Primary cutaneous infection by Aspergillus ustus in a 62-year-old liver transplant recipient

We report the first case of primary cutaneous aspergillosis caused by Aspergillus ustus, a species that seldom infects human beings. The patient, a 62-year-old liver transplant recipient with end-stage hepatitis C-induced cirrhosis, was receiving the experimental immunosuppressive drug FK-506. Trauma to the skin of the right arm from tape and from an arm board holding intravenous and intraarterial catheters in place and to the left leg from an occlusive knee brace may have contributed to this unusual mycosis. The patients cutaneous aspergillosis responded to a combination of intravenous amphotericin B and topical terbinafine cream. Although the patient died shortly thereafter from hepatic failure, there was no evidence of systemic aspergillosis.

Corneal transplant infection by Paecilomyces lilacinus

Paecilomyces lilacinus was cultured from an ulcerated corneal transplant, sections of which, following surgical removal, revealed dense mycelial growth throughout the corneal remnant and penetrating Descemets membrane. PAS-stained sections showed, in addition to the hyphae, numerous small, ovoid elements consistent with conidia of P. lilacinus. Infection apparently had spread to the transplant from the recipients cornea. The fungal isolate proved resistant, in vitro, to amphotericin B, 5-fluorocytosine, and pimaricin, but sensitive to ketoconazole and moderately sensitive to miconazole. Following a second transplant and intensive antifungal therapy, the infection appears to have been eliminated.

Differentiation of yeasts by means of fluorescent antibody.

Summary 1) The Coons fluorescent antibody technic is here extended to differentiation and classification of yeasts. The globulin portion of antiserum produced in rabbits against Candida albicans was labelled with fluorescein isocyanate and applied as a differential stain to dried smears from various yeastlike cultures. 2) All 28 strains of C. albicans tested and all 8 strains of C. tropicalis exhibited positive staining reactions with the anti-C. albicans conjugates. Twenty-one strains belonging to 6 other species of Candida, and 46 strains of yeastlike organisms representing 15 other genera were unstained or only weakly stained, and could readily be distinguished from the preceding 2 species. The staining specificity of high-titered conjugates was greatly increased through absorption with cells of Candida parakrusei. 3) Appropriate controls on the serological specificity of the fluorescent staining, including inhibition and absorption tests, are described. 4) Preliminary results with Blastomyces dermatitidis and Histoplasma capsulatum conjugates are reported.

Malassezia Pityrosporum pachydermatis (Weidman) Dodge 1935

Priority of the name Malassezia pachydermatis (Weidman) Dodge 1935 is indicated for the microorganism which has been called Pityrosporum pachydermatis Weidman 1925 and P. canis Gustafson 1955. M. pachydermatis is here further characterized in culture with information drawn from 2 recent isolates, in particular the presence of spiral grooves on the inner surface of the cell wall, good growth on Mycosel agar, rapid production of urease, and assimilation of glucose by the Wickerham method.

Refinement of fluorescent antibody by gel filtration.

Summary “Gel filtration” through a Sephadex column permits a significantly simpler and more rapid purification of fluorescent conjugates than either anion-exchange or electrophoresis. Dialysis was eliminated and unconjugated dye as well as other low molecular weight fractions were separated with minimum loss of protein or titer. Detailed data on purification of some anti-fungal conjugates are presented. Ethodin extraction of serum antibody preparatory to conjugation and gel filtration further expedites the process.

Phoma (peyronellaea) as zoopathogen

Two case reports add to the rare recorded instances of infection of man and other animals by Phoma or Phoma-like molds. Phoma cava was consistently cultured from aural dermatitis of a white-tailed deer (Odocoileus virginianus), and tissue sections of the ear revealed fragments of apparent pycnidial walls, as well as many septate hyphae. In the second instance, numerous Phoma-like pycnidia occurred in and upon the hairs of a young child, in a lesion initiated by Trichophyton infection.

Paecilomyces lilacinus (Thom) Samson, from systemic infection in an armadillo (Dasypus novemcinctus)

Paecilomyces lilacinus was recovered in culture from pulmonary lesions and other internal organs of a captive armadillo. Impression films and smears of the lung tissue revealed numerous budding yeast-like cells, many of them appearing encapsulated and resembling intracellular forms of Histoplasma capsulatum. Yeast-like forms developed in culture on appropriate media at 35 degrees C. The armadillo isolate was compared in culture at both 27 degrees C and 35 degrees C with bamboo rat and human isolates of Penicillium marneffei. The two species were also subjected to serologic and pathogenicity studies. Sensitivities of the armadillo isolate to five antifungal agents in vitro were consistent with those of three human isolates of this species but contrasted sharply with those of P. marneffei.

Phialophora parasitica, an emerging pathogen

Monoconidial cultures derived from 12 clinical and environmental isolates of Phialophora parasitica were compared with respect to morphologic and physiologic characteristics and response to antifungal agents. No yeast cells were seen in 1- and 3-week-old slide culture preparations. Also, not all of the distinguishing characteristics of this species were displayed by all isolates on all media examined. Although the isolates grew on Sabouraud agar with chloramphenicol and cycloheximide, some inhibition was observed. All cultures were strongly urease-positive and hydrolyzed casein and starch; most decomposed tyrosine but not gelatin. All but one environmental isolate grew well at both 23 and 37 degrees C, but none grew at 40 degrees C. In the sensitivity testing the isolates did not vary much in their response to each drug, although some anomalies were observed. Amphotericin B and miconazole had minimum inhibitory concentrations in the low sensitivity range (2.0-8.0 and 2.5-10 micrograms m-1 respectively), for most isolates, and most isolates were resistant to both 5-fluorocytosine and ketoconazole. Limited observations were made on three other Phialophora species which might be confused with P. parasitica.

Trichophyton (Microsporum?) gallinae ringworm in a monkey

This is the first report of spontaneous infection with Trichophyton gallinae in a monkey and it extends the range of this dermatophyte to the Philippine Islands. The new isolate produced ringworm experimentally in monkeys, guinea pigs and roosters, with typical white-comb lesions and scutula in the birds. Hair involvement was ectothrix in the guinea pig but largely endothrix in the monkey. The significance of verrucose macroconidia in T. gallinae and the proper generic classification of this species are discussed.