The Deep Mycoses (Essentially or Potentially Systemic) -17 



(e) Diagnosis. -This is established In demonstrating In the India ink 

 technic, or by culture, the thick-walled budding cells in centrifuged speci- 

 mens of spinal Quid, sputum, blood or mine (see pp. 336 II. ). 



(I 1 Phogxosis.— When the disease affects the central nervous system 

 the outcome is invariably fatal. This may be partly because in most cases 

 the diagnosis is not made until alter death and suitable treatment lias not 

 been instituted. 



(g) Treatment.— Symptomatic measures are indicated; these include 

 sedation and repeated withdrawal of spinal fluid. Fever therapy may be 

 considered, although we have had no experience. Treatment with the sul- 

 fonamide drugs has been advocated and there are several favorable reports. 

 Tt is advisable to administer both sulfadiazine and penicillin in large dosage 

 and. if improvement is noted, to continue both drugs for several weeks 

 after all symptoms have disappeared. The administration of iodides to 

 the point of intolerance may also be considered. 



BIBLIOGRAPHY 



Hi wham, H. W.: Cryptococci, J. Infect. Dis. 57:255, 1935. 



, and Hopkins, A. M.: Yeast-like fungi found on skin and in intestines oi normal subjects, 



Arch. Dermat. & Syph. 28:532, 1933. 

 Buschke, A.: Ueber eine durch Coeeidien hervorgerufene Krankheit des Mensehen, Deutsche 



med. Wchnschr. 21:14, 1895. 

 Busse, O.: Ueber Saccharomyeosis hominis, Virchow's Arch. f. path. Anat. 140:23, 1895. 

 Cox, L. B.j and Tolhurst, J. C. : Human Torulosis (Melbourne: Melbourne University Press, 



L947). 

 I in mitt. M. S., and Wkidman, F. D. : Generalized torulosis associated with Hodgkin's dis- 

 ease, Arch. Path. 18:225, 1935. 

 Freeman., W.: Torula infection of central nervous svstem, J. f. Psychol, u. Neurol. 43:236. 



1931. 

 , and Wkidman, F. D.: Cystic blastomycosis of cerebral gray matter caused by Torula 



histolytica Stoddard and Cutler, Arch. Neurol. & Psychiat. 9:589, 1923. 

 \o\ Hansemann: Ueber eine bisher nicht beobachtete Gehirnerkrankung durch Hefen. 



Verhandl. d. deutsch. path. Gesellsch. 9:21, 1905. 

 Levin, E. A.: Torula infection of central nervous system, Arch. Int. Med. 59:667, 1937. 

 \l wisiiAi.i., M., and Teed, R. W.: Torula histolytica meningoencephalitis: Recovery following 



bilateral mastoidectomy and sulfonamide therapy, J. A. M. A. 120:527, 1942. 

 Mitchell, L. A.: Torulosis, J. A. M. A. 106:450, 1936. 



Mook, W. H., and Moore, M: Cutaneous torulosis, Arch. Dermat. & Syph. 33:951, 1936. 

 Stoddard, J. L., and Cutler, E. C: Torula infection in man. Monograph 6, Rockefellei 



Institute for Medical Research, 1916. 

 Wkidman. F. D. : Cutaneous torulosis, South. M. J. 26:851, 1933. 

 W'ii.k. I'. [.: Cutaneous torulosis, Arch. Dermat. & Syph. 31:58, 1935. 



10. RHINOSPORIDIOSIS 



This mycosis is uncommon in the United States, the majority of cases 

 being reported from India and Ceylon, with only a few eases from widely 

 scattered parts of the world. 



