TORULEAE 



681 



in the groin and in one patient behind the ear. The lesion begins by swelling 

 of the affected member, nsnally accompanied by one or more nodules, pustules, 

 or abscesses which, upon rupture, become fistulas. New lesions make their 

 appearance near the first until a considerable portion of the member may be 

 involved. The tumor mass begins to soften, and the lesions burst and dis- 

 charge an oily, viscid, seropurulent fluid with small black grains (sclerotia). 

 The overlying skin becomes discolored, usually darker, mottled and scarred, 

 surmounted by discharging sinuses. Pain is usually mild or even lacking, but 

 the resulting deformity often interferes with locomotion. In general, the 

 bones are not affected by Madurella, although they frequently are when 

 Actinomyces is the etiologic agent. Surgical removal of the tumorous mass 

 or amputation is usually the only satisfactory method of treatment. 



In the bibliography at the end of this chapter, I have collected all the 

 references to this disease where the organism was not presumably a species 

 of Actinomyces, Monosporium, or Aspergillus. 



Key to Species 



Colony white. M. Toseuri. 



Colony grayish ashy on carrot, oehraceous on potato, and brown on Sabouraud agar. 



M. Ea/miroi. 

 Colony greenish gray to purplish gray, becoming purplish when old; on Sabouraud agar 



yellowish, then purplish. M. Oswaldoi. 



Colony grayish white, zonate, center brown, folded, becoming dry membrane, deep chamois 



or darker. M. algiris. 



Colony copper yellow, margin greenish yellow, finally covered with a brown pubescence on 



Sabouraud agar; gelatin not liquefied. M. Tabarkae. 



Colony grayish white, becoming liglit brown, gelatin liquefied, sclerotia abundant on Sabouraud 

 conservation agar. 

 Colonies accuminate on Griitz and Sabouraud agar. M. IJcedae. 



Colonies tomentose and cerebriform on Griitz agar, little or no growth on Sabouraud 

 agar. M. americana. 



Madurella Tozeuri (Nicolle & Pinoy) Pinoy, Ann. Derm. Syphiligr. V, 3: 

 341-343, 1912. 



Oospora Tozeuri Nicolle & Pinoy, Bull. Soc. Path. Exot. 1: 95-99, 1 fig., 

 1908. 



Isolated from a growth on the top of the foot, not involving muscles, 

 joints, or bones. Epidermis and dermis only affected. No pain. Lesions 

 eighteen years in developing. 



Hyphae straight or flexuous, l-4/i, in diameter. Cells have thick walls. 

 Chlamydospores 2-6/x in diameter. Hyphae united by a brown pigmented mass, 

 or follow blood vessels, branching at the capillaries. Grains 50-100/a in di- 

 ameter, with outer layer of filaments yellow brown, l-2;tt in diameter. 



Organism cultivated on several media. On glucose or maltose agar, in 

 24 hours at 37° C, white colonies develop with a blackening of the substrate. 

 Same on potato. Media not blackened in the absence of carbohydrates. 



