A CLAD 10 SIS 



2089 



Be Beurmann has put on record a case of mycetoma of spoiotrichic origin. 

 Cases of systemic sporotrichosis have been described. 



Diagnosis. — The principal clinical signs on which to base a 

 probable diagnosis of sporotrichosis are the presence of gumma-like 

 lesions while the patient is in a good general state of health; the 

 mixture of lesions of different appearance; partial cup-shaped 

 softening of the nodes, breaking down in the centre and ending in 

 ulceration, with violaceous edges generally undermined; presence 

 of viscous pus or of a serous lemon-yellow discharge; indolent 

 evolution ; absence in most cases of enlarged glands. The definite 

 diagnosis can only be made by bacteriological methods. The simple 

 microscopical examination of the pus of the abscesses, or scrapings 

 of the ulcers, is not sufficient, as the fungus is extremely scarce. 

 Cultivation must be resorted to. A few glucose-agar tubes are 

 inoculated, and kept at room-temperature without capping. After 

 four to ten days the first colonies of Sporotrichum will appear. 



Treatment. — Potassium or sodium iodides in full doses (15 to 

 20 grains three to four times daily), well diluted in water or milk, 

 induce a rapid disappearance of all the lesions. In persons who 

 cannot take potassium iodide, saiodin in the same dose may be 

 given in cachets. The ulcerated lesions may be dressed with a 

 lotion of potass, iodide 10 parts, iodine i part, water 500 parts. 

 Surgical measures should be avoided. 



Pinoy has noted that the action of the iodides is increased by a salt-free diet. 



Prophylaxis. — Any small wound should be disinfected with tr. iodi. 



ACLADIOSIS. 



Definition. — An ulcerative dermatomycosis caused by Acladium 

 castellanii Pinoy. 



Historical and Geographical Distribution. — The condition has been 

 observed by Castellani since 1907 in Ceylon, but he did not fully 

 describe it until 19 16. Cases have been observed in Ceylon, the 

 Federated Malay States, and Macedonia. 



>ffitiology. — The condition is caused by a fungus "which Castellani 

 isolated in Ceylon. Cultures were sent to Professor Pinoy, of the 

 Pasteur Institute, who investigated it botanically and classified it, 

 giving it the name of Acladium castellanii Pinoy, 1916. Professor 

 Pinoy 's description may be quoted: — 



' The growth on artificial media (such as carrot, potato, glucose agar) 

 consists of many small roundish masses, which later on may coalesce, covered 

 by spiculated formations, giving them a prickly appearance, and consisting of 

 erect, straight filaments, parallel to each other, or at times interlacing. These 

 filaments are approximately 2 microns in diameter, and carry laterally pseudo- 

 conidia of variable shape, cylindriform, pyriform, or spherical, attenuated in 

 size at their points of insertion. Most of these pseudoconidia are 4 microns 

 in length, with a breadth of 3 microns. This t5^e of fructification recalls 

 the type Acladium described by Bodin in certain species of the genus 

 Trichophyton (Malmsten, 1848). 



' These pseudoconidia become detached and then develop by sprouting, 

 and mycelial filaments are formed. Certain filaments produce spherical 



