218 REPORT OF THE HARVARD AFRICAN EXPEDITION 
of a new species Aspergillus nantae which could be distinguished from Aspergillus 
nidulans among other characters by the absence of perithecia in the cultures. 
Emile-Weil, Gregoire, and Flandrin,! in 1927, in a way confirmed these ob- 
servations and have reported upon seven cases of primary splenomegaly produced 
by mycotic infestation. They point out that the condition, however, should not 
be termed ‘‘ Algerian,” because it is equally common in France. The process is 
usually a chronic one. While the clinical diagnosis is frequently difficult, the 
pathological diagnosis is not so on account of the presence of the characteristic 
yellowish-brown nodules, about the size of a millet seed and of the color of iron 
rust, which permit a diagnosis being made by the naked eye. 
Histologically these nodules are said to be absolutely characteristic and are 
surrounded by a congested zone, while the interior is formed of one or more 
vessels sclerosed in their outer coats. Around the vessels there are fibroblasts 
and filaments of abnormal connective tissue; at the periphery many plasma 
cells and true giant cells, sometimes containing fragments of mycelium or spores. 
The whole nodule is stuffed with mycelian filaments recognizable by their 
segmentary structure, and often by their terminal swelling. In other cases, 
large encapsulated spores were found. In two cases cultures of the fungus were 
obtained on Sabourraud’s medium or on ‘‘gelose ascite.”” The growth appeared 
after eight days in one case, and twenty in the other, in the form of whitish 
colonies which enlarged and became dark green. They point out that while 
Pinoy and Nanta? earlier identified the fungus as Sterigmatocystis nidulans, 
Emile-Weil and his associates are inclined to believe it is an Aspergillus. 
In later papers,’ they refer to the causation of Banti’s disease by this 
fungus, and state that it seemed to be the same in all seven cases studied. AI- 
though it was regarded as an Aspergillus, the species was not at first identified, 
but it was pointed out it was not identical with Aspergillus fumigatus. No bac- 
terial infections of the spleen were observed in the sections or in cultures. In a 
subsequent publication the fungus was identified as A. amstelodami.4 
In June 1927, Nanta°® reported upon the study of twenty spleens which had 
been extirpated; three for injury, one for hydated cyst, one for malarial hyper- 
trophy and the remaining fifteen for splenic anaemia. These fifteen could be 
divided into two groups, (1) in which only bacteria were found and no nodular 
lesions similar to those described by Gamna in different diseases of the spleen, 
and (2) in which in addition to bacteria a fungus and nodular lesions were pres- 
ent. He points out that the frequent occurrence of mycotic and bacterial in- 
fections makes it difficult to decide the part played by each in the development 
of the lesions and whether the mycotic infection is primary or secondary. 
Goinard ° in his review of the entire subject in his book upon Algerian spleno- 
1 Emile-Weil, Gregoire, and Flandrin: Bull. et Mém. Soc. méd. des Hépit. de Paris (1927), No. 17. 
1 5 Bilis and Nanta: Académie des Sciences (1927), CLX XXIV, 347. 
8 Gregoire, Emile-Weil and Flandrin: Etiology of Banti’s Disease. Bull. et Mém. Soc. Nat. de 
Chirurg. (1927), LIII, 734; Emile-Weil: Ann. d’Anat. Path. et d’Anatomie Normale (1927), LV, 573. 
* Emile-Weil, Chevallier and Flandrin: Bull. et Mém. Soc. Méd. H6pit. de Paris (1927), LI, 1425. 
5 Nanta, A: Ann. d’Anat. Path. et Anatomie Normale (1927), IV, 573. 
® Goinard: Sur Certaines Splenomégalies Algeriennes. Paris, Lib. Louis Annette (1927). 
