350 An Introduction to Medical Mycology 



BIBLIOGRAPHY 



Frank, L., and Alton, G. M.: Aspergillosis: Case of postoperative skin infection, J. A. M. A. 



100:2007, 1933. 

 Markley, A. J.; Philpott, O. S., and Weidman, F. D.: Deep Scopulariopsis of ulcerating 



granuloma type confirmed by culture and animal inoculation, Arch. Dermat. & Syph. 33:627, 



1936. 

 Myers, J. T., and Dunn, A. D.: Aspergillus infection of hand, J. A. M. A. 95:794, 1930. 



2. INADEQUATE AND CONFLICTING EVIDENCE 



In a report on streptothrichosis, Kovnat and Mezei made the amazing 

 statement that "sporotrichosis, streptotrichosis, nocardiosis, madnra foot, 

 psendo-actinomycosis and other designations all cover the same pleomor- 

 phic organism." They reported a case of fatal pulmonary infection. Twenty- 

 two days after the onset of the disease, fresh sputum treated with 10 per 

 cent potassium hydroxide showed the presence of many brown granules 

 which, crushed and examined microscopically, consisted of spores and my- 

 celium with true branching, suggesting Streptothrix as the causative organ- 

 ism. The authors stated that "continued study of the sputum on plain smear 

 and culture bore out the impression of a streptothrix infection." They re- 

 covered the same organism from pus of a subcutaneous lesion which sub- 

 sequently developed and also noted a similar fungus in a pathologic speci- 

 men of a lesion resembling a sebaceous cyst which had been surgically 

 removed before the onset of the fatal disease. Here the incomplete identi- 

 fication of the fungus leaves one in doubt as to whether the patient died 

 of pneumonia, tuberculosis or a mycosis. 



A case report invaluable in illustrating incomplete evidence and illogical 

 reasoning is that of Hollingsworth. The patient was a man aged 65 who had 

 on the back of one hand a nodular ulcerated lesion of 2/2 years' duration. 

 Several physicians had previously made a diagnosis of cancer. The patient 

 stated that the lesion developed after injury with a thorn. Subsequently 

 lie had come in contact with a cow who had lumpy jaw. Cure resulted when 

 a complete surgical excision was performed. Fungicidal remedies were also 

 employed. The histologic report revealed a "well differentiated, early, 

 squamous cell epithelioma, type 1, not highly malignant." No fungi were ob- 

 served in the pathologic tissue. Material which at operation was thought to 

 be a granule subsequently was found to consist mainly of keratinized cells. 

 In one slide Hollingsworth thought he saw definite evidence of branching 

 mycelium. The case was reported as an unusual example of actinomycosis. It 

 may have been, but no evidence was presented to dispute the histologic evi- 

 dence of epithelioma. 



The cases here mentioned were not carefully selected but are representa- 



