[Aspergillus fumigatus infection of the lung in cystic fibrosis (author's transl)]

In an 8-year-old girl with cystic fibrosis Aspergillus fumigatus infection of the lung was diagnosed. Pot-plant soil as reservior of Aspergillus fumigatus was shown to be the source of inhalable Aspergillus fumigatus units within the clinic. Cystic fibrosis mucus of the patient acted as nutritive substrate for Aspergillus fumigatus. Consequent exclusion of pot plants in housing and hospital rooms is considered necessary for prevention of Aspergillus fumigatus infection in patients with cystic fibrosis.

[Orbital aspergillosis--a contribution to its diagnosis and treatment (author's transl)]

In connection with a case report, the mycological diagnosis and treatment of orbital aspergillosis are reviewed. In a 59-year-old male patient an exophthalmus on the right side could be diagnosed as aspergillosis spreading from the corresponding sinus maxillaris into retro- and peri-orbicular regions, after other causes had been excluded by differential diagnosis. In a biopsy specimen from the retrobulbar tumor, a fungal granuloma was found which, histologically and by isolation of the fungus, could be identified as an infection by A. fumigatus. Because of the good visus of the right eye, no exenteratio orbitae but an enoral revision of the sinus maxillaris, ethmoidal bone, and bottom of orbita was performed.--By infusions of amphotericin B and local washings with pimaricin (natamycin) in the sinus maxillaris and the region of the operation, a complete healing of the mycotic process was achieved.--Since 1 1/2 years, the patient has not had a relaps. This success of therapy was possible by exemplary cooperation of otorhinolaryngologists, ophthalmologists, pathologists and microbiologists.--In view of the prophylaxis of such infections, recent contributions to the epidemiology of aspergillosis are discussed.

Epidemiology of Cryptococcus neoformans

The concept of the epidemiology of Cryptococcus neoformans as the causative agent of cryptococcosis and as a basidiomycetous yeast is based on the fact that bird manure has been until now its only known habitat but not plant material which likewise harbours various nonpathogenic Cryptococcus species. It could be shown that the possible influence of nutritional factors on the morphology and morphogenesis earns attention not only in view of the epidemiology of C. neoformans but of its perfect states, too.

A comparative study of antigens of Aspergillus fumigatus isolates from patients and soil of ornamental plants in the immunodiffusion test

The strikingly frequent and constant presence of Aspergillus fimigatus in the soil of potted ornamental plants kept in private houses and hospitals has been the reason for studying the antigens of the strains found from the diagnostic and epidemiological angles. Culture-filtrate antigens of A. fumigatus strains isolated from the soil of 4 different ornamental plants, epiphyllum (Epiphyllum truncatum), orange tree (Citrus sinensis), Alpine rose (Azalea indica) and Christmas flower (Euphorbia pulcherrima), were compared, in the immunodiffusion test, with antigens of A. fumigatus strains from aspergillosis patients prepared in an identical way. When tested against 8 different sera from different aspergillosis patients there was a good coincidence of results. Control sera from patients suffering from diseases other than aspergillosis, no false-positive reactions could be observed. The findings are discussed in respect of diagnosis and epidemiology.

Serodiagnostic value of extracellular antigens of an actively proteolysing culture of Candida albicans (immunodiffusion-test)

Cell-free, dialysed and concentrated culture filtrate of a Candida albicans strain, after proteolysis in serum-protein medium (bovine albumine), and after growth in Sabouraud glucose broth (for comparison) were used as antigens for the detection of precipitating antibodies in 558 samples of serum originating from defined groups of patients and healthy persons serving as controls. The differing distribution of antibodies against these two antigens as observed in the various groups of our patients calls for further studies of such antigens on the basis of proteolysis within the serodiagnostics of Candida albicans-mycoses.

[Candida tropicalis as causative agent of septicemia (author's transl)]

In connection with microbiological findings in two patients, a report on septicemia caused by C. tropicalis is given. C. tropicalis is second in frequency to C. albicans in man. Because for the different biological properties of Candida species in each case of isolation of such fungi from clinical specimens an identification of the species is obligatory, because the generalizing diagnosis of "Candida mycosis" may be insufficient for the detection of epidemiological and pathogenetic associations. The possible primary resistance of C. tropicalis against the antimycotic 5-Fluorocytosine (Ancotil) is discussed. It is shown that the antigen similarity within the most important Candida species as e.g. between C. albicans and C. tropicalis may cause a false interpretation of serological results concerning the causative agent of the infection. For a safe inactivation of C. tropicalis on human skin, cleaning with 70% isopropyl alcohol for ten seconds is proposed. Because C. tropicalis is entering the human body preferably through food it is discussed whether a microbiological control of food for patients predisposed for such infections should be performed.

[Aspergillus serum precipitins in patients of a lung clinic]

The incidence and distribution of aspergillosis among patients of a lung clinic in West Berlin were recorded. The immunodiffusion test (IDT) was used on sera of 228 patients seen during one day to test for precipitins against A. fumigatus, A. flavus, and A. niger. Precipitating antibodies specific against A. fumigatus were found in five patients, in two of them A. fumigatus was isolated simultaneously from sputum. In order to obtain a clear view of the clinical occurrence of asperigillosis and its course one requires not only serological tests but also the isolation of Aspergillus in culture from sputum or bronchial secretion. IDT is useful for detecting aspergillosis and for screening persons harbouring Aspergillus in their respiratory tract.

Disseminated gonorrhea: diagnosis through contact tracing

Over a 1-year period four patients were seen at the Jewish General Hospital with presumed disseminated gonococcemia. The patients' histories, clinical findings and responses to therapy strongly supported this diagnosis; however, cultures from various sites were negative for Neisseria gonorrhoeae in all four patients. Sexual contacts of these patients were traced and appropriate cultures were found to be positive, demonstrating the importance of tracing sexual contacts to help confirm the diagnosis in such patients.