The Deep Mycoses (Essentially or Potentially Systemic) 221 



in which tlu* lung disease is assumed to be caused by Fungi, usually with- 

 out substantial proof. Monilia albicans may be particularly singled out as 

 frequently blamed because it is found in the sputum of patients with an 

 atypical disorder ol the lungs. During the past few years we have studied 

 the role of fungi in chest diseases. The results show that M. albicans is a 

 frequent secondary invader of diseased tissue (such as carcinoma) but 

 rarely initiates disease. It was thought to be the primary cause of death 

 in only one instance, a conclusion which could not be substantiated by 

 postmortem examination. In three other cases there was good evidence that 

 M. albicans was the causal invader and cure followed the administration 

 of iodides. Our study included specimens from 250 patients. In over 100 

 ambulatory patients in a control series with no pulmonary symptoms, there 

 was a high percentage of air-borne fungi in the sputum, but fewer instances 

 in which M. albicans showed so vigorous a growth. From our observations 

 and study we conclude that one must be careful in assigning a pathogenic 

 role to fungi because they are found in sputum. The air-borne molds, with 

 the exception of A. fumigatus, may be dismissed as unlikely patho- 

 gens. Monilia albicans may very occasionally be pathogenic. The finding 

 of known pathogens such as A. bovis (in granules) and C. immitis must 

 always be considered significant. 



BIBLIOGRAPHY 



Carter, L. A.: Pulmonary mycotic infections, Radiology 26:551, 1936. 



Doub, H. 1'.: Roentgenologic aspect of bronchomycosis, Radiology 34:267, 1940. 



