38 An Introduction to Medical Mycology 



cidioidomycosis showed a positive skin reaction to histoplasmin. Katzenstein 

 concluded that cross-sensitization occurred frequently with blastomycin. 



4. CONJOINT SENSITIZATION TO PENICILLIN 



Recent clinical and experimental studies suggest that penicillin, a 

 derived product of the mold Penicillium, contains antigenic properties 

 similar to those elaborated in superficial fungous disease. The local applica- 

 tion of penicillin in patients with acute fungous disease may provoke a 

 local exacerbation. Injection of the drug parenterally may result in the 

 reactivation of a previous dermatophytid, produce in patients with present 

 or previous active dermatophytosis a vesicular eruption of the hands and/or 

 feet identical with the id reaction, or bring forth erythematovesicular 

 lesions in areas of previous dermatophytosis. 



Cross-sensitization experiments in the guinea-pig, utilizing both skin and 

 uterus as test tissue, disclosed an intimate relationship between sensitiza- 

 tion to penicillin and to T. gypseum infections. Whereas the nature of 

 this relationship is still obscure, available evidence indicates that animal 

 tissues with an induced sensitization to penicillin have likewise developed 

 an allergic reactivity to trichophytin. 



Clinical reactions to penicillin may be classified as ( 1 ) contact dermatitis; 

 (2) sensitization of the vascular bed, resulting in urticaria, angioneurotic 

 edema, serum sickness-like syndrome, erythematovesicular dermatitis, 

 erythroderma id-like reactions and erythema nodosum (shocklike reactions 

 are included in this group); (3) sensitization of other structures, e.g., 

 asthma; (4) toxic effects, causing convulsions (especially after local cere- 

 bral application), peripheral neuritis and possibly agranulocytosis, and 

 (5) indirect effects, precipitating an unrelated infection by destruction of 

 antagonistic bacterial flora. 



5. EXPERIMENTAL FUNGOUS INFECTION IN ANIMALS 



This subject is considered partially in the first part of this chapter under 

 The Trichophytin Test. It is further dealt with in Chapter XXVI. Not all 

 fungi capable of being inoculated into laboratory animals cause a resultant 

 "take." The dermatophytes, or fungi causing superficial infections in man, 

 are about equally divided in regard to their capacity or lack of ability to 

 infect laboratory animals. Bloch and his school did most of their work of 

 establishing basic immunologic principles using a strain of A. quinckeanum. 

 DeLamater and also Henrici used strains of T. gypseum as well as other 

 species of fungi. 



