178 INFECTIONS CAUSED BY MOLDS 



13. Mitchell, J. H., Further studies on ringworm of the hands and feet, Arch. 



Dermatol. Syphilol. (Chicago), 5, 174 (1922). 



14. Neal, p. a., and C. W. Emmons, Dermatitis and coexisting fungous infec- 



tions among plate printers, Public Health Bull. 246, 1939. 



15. Ota, M., and M. Langeron, Nouvelle classification des dermatophytes, Ann. 



parasitol., 1, 305 (1923). 



16. Peck, S. M., Epidermophytosis of the feet and epidermophytids of the 



hands, Arch. Dermatol. Syphilol. (Chicago), 22, 40 (1930). 



17. Sabouraud, R., Maladies du cuir chevelu. III. Les maladies cryptogamiques. 



Les teignes, Masson et Cie., Paris, 1910. 



18. SwARTZ, J. H., and N. F. Conant, Direct microscopic examination of the 



skin. Arch. Dermatol. Syphilol. (Chicago), 33, 291 (1936). 



19. Tate, P., The dermatophytes or ringworm fungi, Biol. Rev., Cambridge 



Phil. Soc, 4, 41 (1929). 



20. Wise, F., and J. Wolf, Dermatophytosis and dermatophytids, Arch. Der- 



matol. Syphilol. (Chicago), 34, 1 (1936). 



BLASTOMYCOSIS 



(American Blastomycosis, Gilchrist's Disease) 



Blastomycosis was first described in 1894 by Gilchrist.*' * In a 

 second case reported by Gilchrist and Stokes ' the fungus causing 

 it was isolated in culture. It was thoroughly studied by Ricketts.® 

 Martin and Smith ^ have more recently published a very useful re- 

 view of the disease and reported in detail several cases. Although 

 not common, it has been reported frequently enough from many 

 parts of the United States to establish it as one of the most impor- 

 tant of the systemic mycoses. 



Clinical. In about half the reported cases of blastomycosis the 

 first complaints were of pulmonary involvement. In a considerable 

 number of the remaining cases the first observed lesions were sub- 

 cutaneous nodules. The distribution of these lesions does not appear 

 to be related to trauma or exposure and it is probable that the pri- 

 mary lesion was actually in the lung and that there was blood stream 

 dissemination of the fungus. Primary blastomycosis of the lungs 

 frequently bears a striking resemblance to pulmonary tuberculosis 

 in its course and symptoms, and is often so mistakenly diagnosed, 

 the first indication of the true nature of the disease being a rather 

 sudden generalization of the infection with the development of sub- 

 cutaneous abscesses. 



In systemic blastomycosis the lungs are involved in 95 per cent 

 of the cases and it is probable that in most of these instances the 

 primary lesion was in the lungs. Pulmonary blastomycosis may 



* Literature citations for this section will be found on page 186. 



