TROPICAL BRONCHOMYCOSIS. OBSERVATIONS ON A NEW 



SPECIES OF EPIDERMOPHYTON FOUND IN TINEA 



CRURIS. A NEW INTESTINAL SPIRILLUM. 1 



By Aldo Castellani. : 



TROPICAL BRONCHOMYCOSIS. 



During the six years of my residence in Ceylon I have often been 

 struck by the comparatively large number of cases of subchronic and 

 chronic bronchitis which the physician on superficial clinical examination 

 would suspect to be of a tubercular nature, while complete investigation 

 shows constant absence of tubercle bacilli in the sputum. The ophthal- 

 mic and cutaneous reactions are negative, and inoculations of the 

 sputum into susceptible animals are also negative. Some of these proved 

 to be cases of bronehospirochsetosis, the condition described by me in 

 1905. In other instances, however, neither spirochsetEe nor tubercle bacilli 

 are found, and in a certain number fungi more highly organized than 

 bacteria are present. These are cases of bronchomycosis. I have encoun- 

 tered at least 20 cases of this affection in Ceylon, basing the diagnosis on 

 the result of the microscopic examination, and have culturally studied 

 the fungi isolated from 4 cases. In Ceylon a mild and a graver type of 

 this disease may be distiguished. In the mild type the patient complains 

 of cough with mucopurulent expectoration. There is no fever, the 

 general condition is fairly good; the physical examination of the chest 

 will show nothing at all, or a few moist and dry rales. In the severe 

 type, the disease closely resembles phthisis, the patient becomes emaciated, 

 there is hectic fever, mucopurulent and bloody expectoration ; the physical 

 examination of the chest reveals patches of dullness, fine crepitations 

 and pleural rubbing. I may cite a few instances of each type. 



Case 1 (mild type). — Mr. B. A., young European, occupation tea-taster, has 

 been in Ceylon eight years, has had no disease of importance. He remains several 



1 Read at the first biennial meeting of the Far Eastern Association of Tropical 

 Medicine, held at Manila, March 12, 1910. 



"Professor of tropical medicine and lecturer on dermatology, Ceylon Medical 

 College; delegate from the government of Ceylon. 



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