[Myospherulosis: a riddle asked by strange bags of marbles. A report of four cases (author's transl)].
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Biomedical subjects
Publications and source records attributed to P Destombes.
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The histological study with Hotchkiss-Mc Manus staining and Grocott silver impregnation of tissues invaded by opportunistic fungi is a rapid and easy means of diagnosis. The inflammatory reactions around the fungus give the certitude that it is a pathogen and not a contaminant. The major opportunists among Canidida, Aspergillus, Mucor, Absidia and Cryptococcus species are presented in local and disseminated lesions, but all fungi, saprophytic in the normal host, can become pathogens in the immunodepressed patient.
The pathologic examination of the brain of a pet cat, suspected of rabies, showed lesions of mucormycosis. The causal fungus, Mucor (Rhizomucor) pusillus was isolated and identified. The authors describe the lesions produced, the experimental pathogenicity for the rabbit and the morphologic and physiologic characteristics of the isolate.
The Pasteur Institute studied 103 mycetoma patients in Somalia between 1959 and 1964. Grains were seen in 94 of them and this, added to cultural features, allowed the diagnosis of 60 pathogens as follows: 44 Madurella mycetomi, 1 Leptosphaeria senegalensis, 7 Pyrenochaeta romeroi (or Madurella grisea), 3 Allescheria boydii, 1 Fusarium sp., 3 Neotestudina (Zopfia) rosatii, and 1 unidentified; 34 were actinomycetes: 24 Streptomyces somaliensis, 4 Actinomadura madurae, 3 A. pelletieri and 3 Nocardia spp. The patients delayed too long in consulting their doctors and health education is vital if amputations are to be avoided. The geographical distribution is related to climate and fungal species. In central Somalia the association of M. mycetomi and S. somaliensis, organisms characteristic of desert conditions, was found; white grain mycetomata and those caused by Nocardia spp. occurred in more humid areas. The study revealed 2 new fungi. One, obtained in culture was called Neotestudina (Zopfia) rosatii. The 3 patients affected, lived in Mudugh (2 in El Bur). The other fungus was not identified. It also was recovered from El Bur and one with similar microscopic characters has been seen in Chad and also in "territoire français des Afars et des Issas". Both fungi are desert species.
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A 34-year-old man had an unusual mummified cutaneous mixed tumor that developed shortly after trauma. The apocrine type of tumor cells and pilar differentiation could explain the presence of mummification.
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Amongst the 4,500 strains of our collection of Yersinia enterocolitica usually non-pathogenic for laboratory animals, 5 or 6 strains appeared to be naturally pathogenic for mice. Using these strains and non-pathogenic strains representing more than 90 per cent of human isolates in the world (biotype 4, serotype 0:3, phagocyte VIII; biotype 2, serotype 0:9, phagotype X3), the pathogenicity for cyclophosphamid treated mice and athymic Nude mice has been tested. Highly pathogenic strains killed conventional as well as cyclophosphamid treated mice. Non-pathogenic strains for conventional mice did not show any pathogenicity for cyclophosphamid treated mice (strain IP161 excepted) but killed 30 athymic Nude mice inoculated with 5 x 10(8) and 5 x 10(5) organisms by the oral or intraperitoneal routes. Nude mice infected intragastrically or intraperitoneally showed signs of enteritis and bronchopneumonia followed by a septicemia. Abscesses were found in the liver, the spleen and the ileal wall. The infection of Nude mice with Y. enterocolitica resembles naturally acquired human infection where 2/3 of the cases are enteritis among under 4-year-old children and where septicemia occurs among immunologically deficient adults. The role of T-lymphocytes and of immune functions in Y. enterocolitica infection is discussed through our model.
Conjunctival and tonsillar sites for malakoplakia have never been previously described. The diagnosis in these presented cases has only been arrived at after elimination of mycosis and parasitic disease. The aetiology remains unknown and the pathophysiology is discussed.
The authors report the fifth case in the literature of an orbital presentation of macrophagic lymphocytic histiocytosis or sinusal histiocytosis. This disease which usually presents in the ganglia is accompanied by a characteristic histological appearance dominated by the taking up of blood cells (lymphocytes, plasmocytes, erythrocytes) by macrophages. Its evolution is benign but its aetiology remains unknown and its treatment uncertain.
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