820 



Blastomycosis 



this form of the disease the lesions are in the internal organs, 

 macroscopically and microscopically resemble tubercles, and 

 can only be differentiated from them by the presence of the 

 blastomyces and the absence of tubercle bacilli. The lungs 

 may be affected, and Walker and Montgomery* mistook a 

 case for miliary tuberculosis of the lungs. They also seem, 

 according to Evans f to have a predilection for the central 

 nervous system. 



There seems to be little reason for believing that there is 

 any other difference than that of distribution between the 



Fig. 276. Giant cell from a cutaneous lesion in blastomycosis, showing 

 a group of blastomyces (Montgomery). 



blastomycetic dermatitis and the blastomycetic granuloma, 

 or that they are caused by different micro-organisms. Re- 

 garding the organisms, however, we are by no means sure 

 that there are not several species. 



Specific Organism. The organism presents a variety 

 of appearances which may be thus brought together: First, 

 there are round and elliptical disk-like bodies that some regard 

 as spores, others as the primitive or yeast form. These 

 measure 10 to 30 {* in greatest diameter, are distinctly doubly 

 contoured, highly refracting, and, though sometimes clear 



* "Jour. Amer. Med. Assoc.," 1902, xxxvni, 867. 

 t "Jour, of Infectious Diseases," 1909, vi, 535. 



