NOTE ON THE PORTAL OF ENTRY IN EXPERIMENTAL CHRONIC 

 PULMONARY (SYSTEMIC) BLASTOMYCOSIS ' 



By H. W. Wade 

 (From the Biological Laboratory, Bureau of Science, Manila) 



That the usual portal of entry in systemic infections by the 

 so-called Blastomyces dermatitidis of Gilchrist and Stokes is the 

 respiratory tract itself has been held by most authors who have 

 discussed the matter. This opinion has seemed justified by the 

 usual absence of cutaneous foci or at least of any but apparently 

 secondary lesions markedly in contrast with the usually extensive 

 pulmonary involvement, evidently of long standing. In sur- 

 prisingly few cases has a distinct history of cutaneous blasto- 

 mycosis preceding the general invasion been obtained. 



The possibility of error in a decision as to the point of origin 

 in a generalized case, based on the evidence of lesions existing 

 late in the disease, has been demonstrated by the findings in 

 monkeys inoculated with this organism. In most of those that 

 have died, especially when the inoculation was peripheral (sub- 

 cutaneous or intramuscular) , pulmonary lesions were found. In 

 all but one animal these were essentially acute, appearing as 

 granulomatous nodules or at the most as small circumscribed 

 abscesses. 



In one animal, in which death did not ensue until after a 

 much longer period than usual, lesions developed that resembled 

 those usually found at autopsy in human cases. 



This monkey (No. 119), a full-grown, vigorous female, was 

 inoculated on March 26, 1917, subcutaneously on the right side 

 of the belly with 3 cubic centimeters of vigorous bouillon culture. 

 A blastomycotic abscess developed within a few days at the in- 

 oculation site, and the inguinal lymph nodes on the same side 

 became markedly enlarged. After about a month the abscess 

 discharged, following which it retrogressed, so that on May 2 

 only a small, shallow ulcer remained. At this time it was noticed 

 that the animal was well along in pregnancy. On June 10 she 

 delivered an apparently normal young one. Though thin, the 

 mother appeared to be in good health. The cutaneous lesion 

 had practically disappeared, there being only a slight induration 



1 Received for publication December 18, 1917. 



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