Appearance of Fungi on Direct Examination -II 



In' present. One rarely observes the fructification bodies which are seen 

 when pathogenic fungi are cultured on artificial mediums. Alter treatment, 

 nail tissue may be the only available source ol infected material in which 

 fungi can be demonstrated. 



In nails invaded In M. albicans, when the marginal discolored and under- 

 mined tissue is examined, clusters ol round cells in mosaic pattern are to be 

 found. Filaments are rarely seen. Oil droplets must he differentiated from 

 the yeastlike cells. 



6. PUS 



When material from the contents of superficial pustules or blebs is .ex- 

 amined, fungi are rarely found. Pus aspirated from deeper lesions or re- 

 moved from a discharging sinus should be examined for the structures of 

 one ol the fungi which produce granulomas. Granules or noticeable small 

 clumps of organisms may be quickly observed when a drop of fresh pus on 

 a slide is covered with a cover slip. They usually denote an Actinomvces. 

 Sporotrichum schencki is difficult to demonstrate in direct preparations. 

 The budding micro-organism of Blastomyces and the endospores of Coc- 

 cidioides may be found. More detailed descriptions will be found in the 

 section on the various deep mycoses. 



7. SPUTUM 



The direct examination usually is not reliable, even if the specimen is 

 centrifuged, since contamination is hard to eliminate. However, Actino- 

 myces bovis and M. albicans are both recognizable in the forms in which 

 they appear. It is well known that fungi are notorious as secondary invaders 

 in pathologic tissue. As such, they may also harm the host. Cultural studies 

 followed by critical analysis and correlation with clinical facts are here 

 doubly advisable. Dickson has shown that C. immitis is not uncommonly 

 observed in the sputum of patients in the San Joaquin Valley of California 

 who have a febrile pulmonary disorder. 



8. FECES 



In routine examination for M. albicans, cultural technic alone is gen- 

 erally used. If care is taken that the specimen is not contaminated with 

 air-borne fungi, there is usually no difficulty in obtaining a growth of M. 

 albicans. Bacteria in the specimen do not grow well on acid dextrose agar 

 at room temperature. 



