348 An Introduction to Medical Mycology 



was isolated, Markley, Philpott and Weidman stated that although the 

 micro-organism was not identified either in pus or in histologic section 

 they believed it to be the cause of the disease because ( 1 ) there was reason- 

 able exclusion of other etiologic factors, (2) granulomas were produced 

 in experimental rats, (3) the parasite remained viable for 37 days in such 

 animals, (4) the reports of others indicated pathogenicity of a similar 

 strain and (5) the pus from which cultures were secured came from a 

 closed lesion. There is no doubt that the evidence is strongly in favor of 

 the conclusions drawn. Weidman had previously considered Scopulariop- 

 sis as capable of causing tinea unguium. We have obtained strains of Scopu- 

 lariopsis on a number of occasions, frequently in repeated scrapings from 

 the same patient, but when nails are undoubtedly invaded by fungi, this 

 finding has, with one exception, been incidental. Usually Scopulariopsis 

 was present superficially and the real pathogen was found in the deeper 

 parts of the nail. In the one exception, repeated cultures at various depths 

 of the nail continued to yield a species of Scopulariopsis. The partial evul- 

 sion, achieved as the result of taking specimens, resulted in cure. 



In many cases reported in the last few years a species of Aspergillus has 

 been considered of pathogenic titer. A critical analysis of many of the re- 

 ports fails to reveal sufficient evidence to incriminate the mold as more 

 than an incidental contaminant. In a case reported by Myers and Dunn, 

 an ulcerated granulomatous lesion had been present on the back of the 

 hand for two years. Only a staphylococcus was obtained on blood agar 

 cultures. Roentgen therapy and moist boric acid packs were administered 

 for six weeks without improvement. Then cultures on Sabouraud's medium 

 yielded an Aspergillus. Cure was credited to the use of an ointment con- 

 taining 1 per cent copper subacetate, although it would be more logical 

 to assume that the roentgen rays (dosage not mentioned) administered 

 while the diagnosis was still pyoderma were more than mildly contributory 

 to the favorable result. This case was cited by Frank and Alton, who in 

 turn reported in detail an extremely superficial infection, said to be due 

 to Aspergillus niger in a postoperative skin dressing, which healed over- 

 night after an application of iodine and alcohol. They had observed two 

 similar cases previously. It is a question whether many saprophytes under 

 the same condition would not have produced a similar picture. Frank and 

 Alton stated that of 375 species of Aspergillus, 57 are pathogenic and 40 

 are pathogenic for human beings. The term pathogenic seems to be rather 

 loosely interpreted by these authors. The reports cited could be multiplied 

 many times; this is one reason why medical mycology has become confused. 

 Careful attention to technic in removing material for culture will usually 

 result in the elimination of surface contaminants. 



