SPOROTRICHOSIS 330 
phonuclear leucocytes and round cells with spores of the fungi. The papillae are 
also frequently infiltrated. While there is considerable newly-formed granu- 
lation tissue in the corium, polymorphonuclear leucocytes are very numerous 
and their presence in such large numbers, as well as their inclusion by endothelial 
leucocytes is a prominent feature of the inflammatory process. Very few iso- 
lated giant cells have been found. No acid-fast bacilli were observed in the sec- 
tions and no spirochaetes in those stained by Levaditi’s method. 
Although the two culture tubes inoculated from this case were sealed at the 
time with the object of making a future study and identification of the micro- 
organism upon our return to the United States, the entire surface of the media 
of both tubes was covered with a thick brownish growth of micro-organisms that 
had evidently contaminated the tubes from the air, and no further identification 
of the original fungus could be made. The fungus observed in this case, how- 
ever, obviously differs in some respects from the Sporotrichum beurmanni. 
The round spores are of larger size (No. 260) and also are found in considerable 
numbers in the deep necrotic zonal lesions. Their appearance and manner of 
occurrence (in several articulated cells for example) is different from S. beuwr- 
manni and S. schencki. Brumpt' states the spores of Rhinocladium beurmanni 
are oval and brown, varying from 3 to 5u in length and 2 to 4u in width. In a num- 
ber of cases with infection with S. bewrmanni and S. schencki, it is stated that the 
organism itself usually has not been observed in the tissues or film preparations 
made from them, but only has been obtained by cultures. In some of these re- 
ports there is some doubt as to whether the organism cultivated was not a sapro- 
phytic invader either of the wound or of the cultures from the air. 
Some of the descriptions of the nine species of Sporotrichum isolated at vari- 
ous times by different observers have not always been made by those with special 
knowledge of the study of mycology and hence cannot always be regarded as 
entirely reliable. Also, the pathogenic action of some is doubtful. Usually 
when marked and definite lesions are produced by fungi, the organisms or the 
spores are present in sufficient numbers to be demonstrable by the microscopical 
examination as well as often by culture. 
Hyslop, Neal, Kraus, and Hillman? have recently reported a case of meningi- 
tis due to Sporotrichum. As is quite clear from their illustrations of microscopical 
preparations of the spinal fluid, as well as of sections of the tissues, the sporo- 
tricha were present in sufficient numbers to be found without difficulty. While 
careful search of each smear revealed in every instance the presence of the spore- 
like bodies, they failed to secure any positive cultures, either by aerobic or anaero- 
bie methods. Since the organisms were constantly present, they were unable to 
understand why their numerous attempts at cultures failed. Dr. Elser reported 
to them that in one case of skin sporotrichosis in which positive cultures could 
not be obtained, he considered it possible that iodine medication might have 
affected the organism so that it would not grow in cultures. As soon as the 
diagnosis was made in Hyslop’s case, intensive iodide therapy was begun. In 
1 Brumpt: ‘‘Précis de Parasitologie” (1927), p. 1322. 
2 Hyslop, Neal, Kraus, and Hillman: Amer. Jour. Med. Sci. (1926), CLX-XII, 726. 
