228 An Introduction to Medical Mycology 



three or four weeks. On the average, seven to 10 days elapse before a defi- 

 nite report of the species of infecting fungus can be delivered. 



The large majority of specimens intended for mycologic examination are 

 derived from the cutaneous surface. These include scales, macerated skin, 

 pieces of nail, the roofs of vesicles, pustules or bullae and hairs. At times the 

 specimen may consist of pus from deep cutaneous lesions (either open or 

 closed) or from an internal source (such as an appendiceal abscess). The 

 material may be one of the body fluids, such as blood (for histoplasmosis?), 

 spinal fluid (for torula?) or bile. The sputum usually contains one or more 

 species of fungi. Due care must be exercised in differentiating between the 

 pathogenic and the saprophytic fungi which will be obtained. Study of the 

 oral mucosa (particularly of the tongue) and of the stool (especially in 

 cases of moniliasis ) is frequently an integral part of the mycologic examina- 

 tion. Routine examination of a vaginal discharge is probably a good policy. 



Pathologists are frequently called on to make an unequivocal diagnosis 

 from specimens of tissue taken by biopsy or post mortem. There is often a 

 close resemblance between the mycoses of granulomatous nature and tuber- 

 culosis and, in the absence of the infecting micro-organism, a definite diag- 

 nosis without directive clinical information may be impossible. As in tuber- 

 culosis, the fungous disease may be acute, in which abscess formation 

 results, or chronic, with the development of giant cells, often in tubercle- 

 like fashion, together with plasma cells, lymphocytes, epithelioid cells and 

 occasional mast cells. 





