Biomedical subjects
Publications and source records attributed to W Kaplan.
A nodule from the infrapatellar region of the left knee of a patient in Israel was found by fluorescent antibody staining to contain the tissue form cells of Blastomyces dermatitidis. The diagnosis was confirmed by culture and other mycological studies when a second lesion appeared below the right knee. This represents the first autochthonous case of blastomycosis from Israel and the Middle East.
Evidence that algae are pathogens was provided by the results of electron microscopic studies of tissues from five cattle and sheep suspected of having green algal infections. Chloroplasts were demonstrated in the algae in each case. Prototheca organisms, considered by some to be achloric mutants of green algae, are causative agents of disease in man and animals and may appear morphologically similar to green algae in tissue. However, electron microscopy showed that chloroplasts were absent in these organisms. Light microscopy revealed not only similarities in size, shape, and mode of reproduction, but also a striking difference between the Prototheca organisms and green algae. Unlike Prototheca, the green algae contained abundant cytoplasmic starch granules that were strongly positive by several staining procedures; these granules, which were PAS-negative following diastase digestion, provide a means of differentiating green algae from Prototheca cells in tissue.
A 57-year-old man, who for many years was treated for a pleomorphic lymphoma with cytotoxic drugs and x-ray therapy, died from the generalized tumor process. At autopsy, an extraordinary finding was found in form of acute pulmonary mycosts, which histologically appears to be histoplasmosis. Culture was not attempted, but the diagnosis is based on morphology, both of the organism proper and its intracellular location, and on results obtained by immunofluorescence studies. In numerous pulmonary vessels, endothelial pillows of histiocytes with yeast cells are found, typical for histoplasmosis, but no generalization was found in other organs. The source of the infection is not clear.
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A severe necrotizing granulomatous lymphadenitis caused by Sporothrix schenckii was diagnosed in a Pacific white-sided dolphin (Lagenorhynchus obliquidens) that had been in captivity for about 3 years. Histopathologic and electron microscopic studies, as well as fluorescent antibody techniques, were used to identify S schenckii as the etiologic agent.
The primary objective of this study was to determine whether freezing sputa in dry ice had any effect on the recovery of pathogenic fungi. Sputa seeded with each of five fungi (Histoplasma capsulatum, Blastomyces dermatitidis, Cryptococus neoformans, Coccidioides immitis, and Aspergillus fumigatus) were frozen and stored for 24, 48, and 72 hours on dry ice. H. capsulatum was killed, and only a few colonies of B. dermatitidis and C. neoformans were isolated from these sputa. However, A. fumigatus and C. immitis withstood the effects of freezing. A second objective was to compare the recovery of all five fungi from seeded sputa stored at room temperature for 24, 48, and 72 hours, on yeast extract-phosphate agar with NH4OH and on Sabhi agar. The yeast extract-phosphate agar with NH4OH was superior to Sabhi agar, for the isolation of all fungi studied, except A. fumigatus.
Two experiments were conducted to determine whether the chick's attraction toward specific rates of intermittent sound stems from long-term prehatch exposure by the chick to its own fetal heart beat. Contrary to prediction, Experiment I showed stronger attraction toward an intermittent square wave white noise signal matched for pulse rate, overall pulse duration, and mean intensity, than the sound of the actual fetal heart beat from which this attraction is said to derive, Experiment II demonstrated that long-term prehatch exposure to an intermittent auditory signal having a normally non-preferred rate will not establish an attraction for that same rate after hatching unless it contains a frequency component having latent appetitive properties. Alternatives to the cardiac self-stimulation hypothesis are discussed and, in the context of related evidence, the fetus' general capacity for exposure learning is reconsidered.
A case of laboratory-acquired sporotrichosis was diagnosed by immunofluorescence and by culture. The patient was then cured by treatment with oral potassium iodide. The need to handle cultures of Sporothrix schenckii with due caution is stressed.
Cell walls of Histoplasma capsulatum yeast-form chemotypes 1 (chem 1) and 2 (chem 2) treated sequentially with several polysaccharolytic enzymes and Pronase yielded soluble, nondialyzable polysaccharides at each step, which were analyzed for monosaccharides, protein composition, and serological activity. Polysaccharide recovered after digestion of chem 1 walls with beta(1-->3)-glucanase contained glucose > mannose > glucosamine > galactose. This fraction (chem 1 betaG(1)) was analyzed by polyacrylamide gel electrophoresis and contained a component having an apparent molecular weight of 120,000. The chem 1 betaG(1) fraction was reactive in immunodiffusion (ID), producing an immune precipitate not identical to the H and M factors of histoplasmin. In a side-by-side ID comparison with extracts of chem 2, the chem 1 betaG(1) antigen contained an additional determinant not found in chem 2 extracts when tested with goat antiserum to H. capsulatum. Therefore, the chem 1 antigen gave preliminary ID evidence of antigenic group specificity. A chemical difference observed was the absence of glucosamine from chem 2 polysaccharide. In complement fixation (CF) tests, 9 of 17 sera from human histoplasmosis patients reacted with chem 1 betaG(1), but some cross-reactivity with sera of patients with other systemic mycoses occurred. The immunoelectrophoretic patterns of chem 1 wall-derived polysaccharides showed a marked shift in mobility after Pronase digestion, implying the presence of covalent peptides. The ultrastructural appearance and serological activity of intact walls and enzyme-resistant mural cores were also studied. The surface of the mural cores of both chemotypes was perforated and frayed. In shadow-cast preparations both fibrillar and globular areas persisted in the mural cores. The CF end point serum dilutions showed an increase after alpha- and beta-glucanase extractions of chem 2 walls and fourfold reduction after Pronase digestion. The mural cores of both chemotypes were still reactive in CF tests and retained some ability to bind fluorescent antibody. The chem 1 mural core reacted with specific fluorescein-labeled H. capsulatum antiglobulins produced by adsorption with Blastomyces dermatitidis, thus indicating at least partial retention of H. capsulatum-specific factors. The presence of galactose, mannose, and glucose was detected in the mural cores as well as enriched levels of amino sugar, despite exposure to chitinase.
Structures resembling the cyst form of Pneumocystis carinii were noted in the lungs of alloxan-diabetic rabbits to whom spores of several species of fungi belonging to the class zygomycetes had been administered by intranasal instillation. At 24 to 168 hours after the instillation of spores, these rabbits succumbed to diabetes or zygomycete infection, or both, and the possibility of a mixed infection with both fungus and P. carinii could not be ruled out on morphologic criteria alone. To resolve the dilemma, rabbit lung tissue was examined by the fluorescent antibody procedure with labeled P. carinii antibodies. The labeled antibodies did not stain structures that resembled P. carinii but stained P. carinii cells in control rat lung infected with this organism. Investigators should be aware of the difficulty that may arise in differentiating the cyst form of P. carinii from spores of some fungi. The direct fluorescent antibody procedure for P. carinii appears to be very useful for differentiating P. carinii cysts from fungal spores.
The isolation of Histoplasma capsulatum from a bat cave in the Galilee region of Israel is reported along with the discovery of a bat (Myotis myotis) infected by H. capsulatum. Soils collected in avian and chiropteran habitats throughout Israel also yielded the following fungi of medical interest: Arthroderma quadrifidum, A. tuberculatum, Candida parapsilosis, Chrysosporium indicum, C. keratinophilum, C. tropicum, Cryptococcus neoformans, Ctenomyces serratus, Microsporum gypseum, and Petriellidium boydii. All available reports concerning the occurrence of H. capsulatum and histoplasmosis in the Middle East are critically reviewed.
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Pulmonary nocardiosis was diagnosed in an adult male orangutan (Pongo pygmaeus) being maintained in an outdoor facility. Periodically, the orangutan had had clinical signs of an upper respiratory tract infection, as evidenced by slight nasal discharge and cough. At the terminal stage, the orangutan had acute respiratory embarrassment, with epistaxis, and died before diagnosis could be made and treatment initiated. Gross necropsy findings included fibrosis of the pulmonary parenchyma as well as evidence of air sac infection, extensive pneumonia, and extensive chronic pleuritis. Microscopically, some of the lung sections had alveoli filled with polymorphonuclear cells, with other sections being diffusely fibrotic; the areas of fibrosis contained interspersed foci of polymorphonuclear cell infiltration. Many of the latter areas contained organism colonized in the form of granules that resembled those seen in actinomycosis. These organisms were gram-positive and branched, and measured close to 1 mum in diameter. Nocardia asteroides was isolated from the pulmonary tissue.
A 12-year-old Domestic Shorthair cat with a soft, fluctuant, subcutaneous mass, approximately 5 cm in diameter on the posterior aspect of the left tarsus was diagnosed as having protothecosis. Cultures, histopathology, and fluorescent antibody reagents were used to identify Prototheca wickerhamii as the etiologic agent. Protothecosis has not previously been recorded in cats.
The effect of cetylpyridinium chloride (CPC) on pathogenic fungi and Nocardia asteroides was studied. Sputa seeded with each of 11 organisms (Aspergillus flavus; Aspergillus fumigatus, Blastomyces dermatitidis, Candida albicans, Coccidioides immitis, Cryptococcus neoformans, Geotrichum candidum, Histoplasma capsulatum; Nocardia asteroides, Paracoccidioides brasiliensis, and Sporothrix schenckii) were treated with CPC and kept for 2, 5 and 9 days. The CPC reagent used (0.5% CPC and 0.5% sodium chloride) is one the Mycobacteriolgoy Branch at the Center for Disease Control added to sputa before shipping them to laboratories for recovery of mycobacteria. None of the organisms tested survived this treatment, and none was recovered on mycological or mycobacteriological media. Seeded sputa containing these organisms were also tested with a second CPC reagent (0.02% CPC and 0.5% sodium chloride) and held for 2, 5 and 9 days. A few colonies of A. flavus, A. fumigatus, and N. asteroides were recovered from these samples. Neither the morphology of the fungi nor their stainability by the fluorescent antibody method was affected by treatment with the reagent containing 0.5% CPC. However, the background material in smears from the 0.5% CPC-treated samples retained the conjugate, and this made weakly fluorescing organisms more difficult to detect. The 0.5% CPC treatment did not alter the morphology of N. asteroides or its ability to be stained with Kinyoun acid-fast stain.
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Spontaneous fatal aspergillosis occurred in several species of parrots imported from Latin America, Australia, Malaya and Ghana for studies on the control of psittacosis. Over a period of 4 years, 655 parrots were imported for use in these studies. All birds that died during these investigations were necropsied, and the internal organs of 45 were found to have macroscopic lesions suggestive of aspergillosis. Of these 45 suspected cases, 32 were confirmed as aspergillosis by both histopathology and culture, and three others by histopathology alone. There was no evidence that the remaining 10 had this disease. Of the 32 culturally confirmed cases, 13 were found to be caused by Aspergillus fumigatus, 16 by A. oryzae, and three by both fungi. In this series, three sets of circumstances appear to have been associated with the development of fatal aspergillosis. Their capture and transport to the United States, the administration of chlortetracycline used in the control of psittacosis, and the administration of cortisone acetate in an attempt to activate existent latent psittacosis infections. The possible causal relationship of these factors are discussed.
A slowly evolving subcutaneous mycosis in a 10-year-old domestic shorthair cat was found to be caused by Drechslera spicifera, the imperfect state of ascomycete Cochliobolus spicifer. The cat had circular, nodular, granulomatous lesions over its sternum. Scattered individual and small groups of septate hyphae and chlamydospores were found in histologic sections. Many of the hyphae also had bizarre dilatations. Most of the fungal elements were hyaline; a few, however, were dematiacious. Because the fungus was not organized into granules in tissue, the disease could not be classified as a mycetoma. The preferred name for infections of this type is phaeohyphomycosis.