THE PATHOGENIC FUNGI 985 



France isolated a similar parasite from a myxornatous tumor of the 

 leg. 



Numerous cases of infection with yeast-like organisms have since 

 been described. In a case reported by Zinsser 10 the lesion was an 

 abscess of the back involving the spine. The parasite corresponded 

 morphologically to Busse's. Animal inoculation in rabbits and 

 guinea-pigs proved positive and the organism seemed to show a 

 selective preference for the lungs and spleen. In the lungs of the 

 animals, especially, lesions were found with surprising regularity 

 even when the inoculation was made intraperitoneally. 



Clinically there are two distinct types of this disease, the blasto- 

 mycetic dermatitis of Gilchrist and the systemic blastomycosis. The 

 former is by far the more common. Of the latter a collection of 

 forty-seven cases was made in 1916. " The portal of entry in many 

 of these has seemed to be the respiratory tract, the earlier lesions 

 being in the lungs. In other cases the general infection has followed 

 a cutaneous lesion. The skin and subcutaneous tissues show the 

 most numerous secondary lesions but the bones, liver, spleen, kidney 

 and brain have each been involved in several instances. 



BLASTOMYCES HOMINIS 



(Sacchnromyces hominis, Busse; Cryptococcus Gilchristi, Vuillemin; 

 Zymonema Gilchristi, de Beurmann and Gougerot; Mycoderma 

 dermatitis, Brumpt ; Oidium Hektoenii, Ricketts) 



The parasites causing this disease probably represent a group 

 of allied organisms rather than an individual species. As seen in 

 the tissues or exudates they have shown a marked similarity in 

 all cases. In the abscesses of the generalized form they are very 

 numerous, in the cutaneous form somewhat more difficult to find 

 and are best sought in the small epidermal abscesses which border 

 the lesion. In an unstained moist film of pus spread out between 

 a cover-slip and slide they appear as round or occasionally oval 

 highly refractive bodies containing granules of various sizes and 

 often vacuoles and surrounded by a hyalin capsule. They vary 

 greatly in diameter usually from 10 to 20 microns. Budding forms 



10 Zinsser, Proc. New York Path. Soc., 1907, vii. 



11 Wade and Bel, Arch. Int. Med., 1916, xviii, 103. 



