Immunity and Cutaneous Sensitization 37 



2. THE OIDIOMYCIN TEST 



In an investigation ( in which Royal Montgomer) collaborated ) of the 

 tost with oidiomycin, a commercial vaccine made from M. albicans, we 

 concluded that the information obtained from the test was rarely useful. 

 Sensitization of the skin might occur from a focus in the intestinal tract or 

 from a lesion which had subsequently resolved. Of 42 patients having 

 some form of localized cutaneous moniliasis, a positive response to the 

 test was noted in 57 per cent. Of 91 patients with an infection due to a 

 fungus other than M. albicans, 45 per cent showed a positive reaction, 

 while of 192 patients with no evidence of any type of fungous infection, 

 46 per cent reacted. In a second series of tests ML albicans was found to be 

 present in cultures of material from the tongue, skin or stool of 52 of 100 

 patients. The test produced a positive reaction in 58 per cent of the 

 patients with positive cultures and in 54 per cent of those with negative 

 cultures; the similarity of results is noteworthy. 



From these findings, which substantially agree with those of Biberstein 

 and Epstein and of Staehelin and his co-workers, it is obvious that the 

 test has no practical value in the diagnosis of infections due to M. albicans. 

 We advise that the oidiomycin test be abandoned. 



3. OTHER CUTANEOUS TESTS 



We came into the possession of a supply of coccidioidin through the 

 courtesy of the late Ernest C. Dickson, of Stanford University, and have 

 tested the cutaneous sensitivity of over 400 patients who had various 

 dermatoses, many with some form of infection due to a dermatophyte. 

 In only one instance we observed a weakly positive reaction to the test. 

 This is important, since the patients tested lived in New York and gave 

 no history of a prolonged stay in the part of California where granuloma 

 coccidioides is endemic. There is ample proof that the coccidioidin test is 

 highly specific. The same conclusions may be drawn with respect to blas- 

 tomycin and sporotrichin. With blastomycin, in contradistinction to coc- 

 cidioidin and sporotrichin, negative reactions to the test may be encoun- 

 tered in the presence of the active disease. The histoplasmin test may be 

 negative in a patient with active histoplasmosis. Positive reactions usually 

 may be found in patients with the rapidly fatal type and also in patients 

 who apparently have an abortive form. Occasionally cross-sensitization 

 or false positive reactions may be noted for blastomycin and histoplasmin. 

 Fishman stated that 60 per cent of several hundred patients with coc- 



