THE PATHOGENIC FUNGI 993 



a chain extending up the arm, connected by thickened lymphatic 

 vessels. They slowly soften and ulcerate. 



The first cases described were those of Schenck 29 and of Hektoen 

 and Perkins 30 in this country. It is a rare infection here, but 

 twenty-eight cases being reported up to 1912. 31 In France and 

 Switzerland it is relatively common and our present knowledge of 

 the disease is based chiefly on the work of de Beurmann and 

 Gougerot. 32 It may be caused by several species of hyphomycetes 

 belonging to the genus sporotrichum. 



SPOBOTRICHUM 



It is difficult and often impossible to demonstrate the parasites 

 by direct examination. When found in smears of the pus, or in 

 sections of the lesions, they appear as oval or cigar-shaped cells 

 varying in length from 10 to 2 and in breadth from 3 to 1 microns. 

 These are frequently within large mononuclear phagocytes. The 

 parasites may be demonstrated by clearing the pus with 40 per cent 

 NaOH or by staining with thionine or other basic stains. They are 

 Gram-positive. 



Cultural Characteristics. As a rule the organism can be found only by 

 making cultures from the pus or from the bloody fluid aspirated from 

 firmer lesions. Tubes of Sabouraud's test medium or of 4 per cent 

 glucose agar should be heavily inoculated on the surface and incubated at 

 room temperature. Taylor 33 recommends glycerine-glucose-agar to which 

 acetic or citric acid (1-1500) is added. The colonies appear in four days 

 or more as minute gray flecks, soon surrounded by a delicate fringe. The 

 centers as they enlarge become raised and wrinkled and darken to a buff, 

 or chocolate, or in some species to a black color. In flask cultures they 

 may attain a diameter of 10 cm. and more. At the periphery is a smooth 

 flat zone with delicate radiating outgrowths, which, if they reach the side 

 of the tube, grow upward along- the dry glass. The surface is usually hard 

 and glistening but in old cultures may show hairy or powdery outgrowths 

 from the surface. 



The sporothrix grows on media of very simple composition but more 



29 Schenck, B. R., J. Hopkins Hosp. Bull. 1898, ix, 286. 



80 Hektoen, L., and Perkins, C. F., Jour. Exp. Med., 1900, V, 77. 



81 Hamburger, W. W., Jour. Am. Med. Assn., 1912, LIX, 1590. (Bibliography.) 



82 de Beurmann and Gougerot, Les Sporotrichoses, Felix Alcan.,, Paris, 1912. 

 u Taylor, Kenneth, Jour. Am. Med. Assn., 1913, LX, 1142. 



