Biomedical subjects
Publications and source records attributed to R Vanbreuseghem.
The clinical manifestations of "opportunistic" fungal infections in compromised hosts, asthenomycoses, differ from those caused by the same fungus in otherwise normal people. Examples are given on the field of dermatophytoses, aspergillosis, candidiasis and cryptococcosis.
Dematophytes invade hosts when their state is suitable for the production of their pathogenicity. When the host's resistance is reduced, the prevalence of dermatophytoses can be extremely high or the symptomatology can be very unusual. It is suspected that the 'maladie dermatophytique' and pherhaps dermatophytic mycetoma develop in such situations. The fact is that the behaviour of dermatophytes does not differ from that of the so-called opportunistic fungi and in some cases it is possible to speak of dermatophytic asthenomycosis.
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In light of his experiences especially in tropical regions, the author makes some remarks about dermatophytes and dermatophytia, which they cause. The following main items are: 1. The dermatophytes lead a saprophytic life. 2. Exceptionally, they can invade nonkeratinized tissue and cause "dermatophytic disease", perhaps mycetomas. 3. 45 percent of the ringworm of the scalp heal before puberty. 4. In the tropical regions, trichophytosis caused by endothrix-species are often of inflammatory nature, the favus appears often without scutula formation (afavic). 5. One can heal a substantial percentage of the ringworm of the scalp with a single dosis of 12 tablets (125 mg each) of fine particle griseofulvin. 6. Athlete's foot has also other causes than only dermatophytes.
A classification of mycoses, depending upon the depth of penetration of the organism is discussed, as is the need to distinguish the true from the 'pseudo' mycoses. The development of antifungal agents is described from the first antibiotics to amphotericin B and 5-fluorocytosine. Attention is particularly focussed on the question of safety and effectiveness. Finally, it is stressed that successful antifungal treatment must depend upon determination of the exact pathological status of the patient and examples are given which relate to such clinical assessments.
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Dermatophytes are classified according to two systems. The first, or parasitic classifications of Sabouraud, rests on the morphology of the dermatophytes on the hair in vivo (Achorion, Trichophyton endothrix or ectothrix microides and megaspores, Microsporum) or on the absence of growth on the hair in vivo (Epidermophyton). In the second type they are classified according to their saprophytic morphology. There are many classification of this type based on the asexual state of the dermatophytes, e.g. the classification of Emmons (Trichophyton, Microsporum, Epidermophyton) or the classification of Vanbreuseghem and De Vroey (Microides, Trichophyton, Microsporum, Epidermophyton, Keratinomyces). As the existence of a sexual state of the dermatophytes has been demonstrated, the dermatophytes are also classified in two perfect genera: Arthroderma and Nannizzia. In this paper it is assumed that both classification have to be used because they are not correlated.
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The author revises the main clinical aspect of the disease as well as its dignosis and its treatment. Rhinosporidium seeberi, first described by J.R. Seeber in 1900, then exhaustively investigated by J.H. Ashworth in 1923, has been accepted up to now as a phycomycete. Inside of the sporangial bodies, part of the polyp characteristic of the disease, are found spores, and in the spores, spherules, considered by Ashworth as food material. In 1955 the author did challenge the view of Ashworth because he had been able with the Feulgen stain to demonstrate the presence of DNA attached to the spherules. The results obtained by Vanbreuseghem were confirmed in 1964 by W.A.E Karunaratne and R. Cameron and Dorothy Russel. They were later confirmed in India by Lakshmanan. In an effort to understand better the real nature of Rhinosporidium seeberi which so far has never been successfully cultivated or inoculated in any animal, a study with the ultramicroscope has been done. Although it is difficult from the results obtained so far to decide of the real nature of R. seeberi, no proof has been found to confirm the theory of Ashworth. Quite evidently much has to be done to decide of the real nature of this interesting parasite.
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