The Pathologic Anatomy of Mycoses: Human Infection with Fungi, Actinomycetes and Algae

1209 Pages·1971·50.79 MB·English

by  Roger Denio Baker M.D.

HANOBUCH DER
SPEZIELLEN PATHOLOGISCHEN
ANATOMIE UNO HISTOLOGIE
BEGRONDET VON
O. LUBARSCH F. HENKE
UNO
FORTGEFOHRT VON
R. ROSSLE
HERAUSGEGEBEN VON
E. UEHLINGER
ZORICH
DRITTER BAND
ATMUNGSWEGE UNO LUNGEN
HERAUSGEGEBEN VON
E. UEHLINGER
ZORICH
FUN FTER TEll
SPRINGER-VERLAG
BERLIN· HEIDELBERG· NEW YORK
1971
THE PATHOLOGIC ANATOMY
OF MYCOSES
HUMAN INFECTION· WITH FUNGI
ACTINOMYCETES AND ALGAE
BY
ROGER DENIO BAKER
AND
A. ANGULO O .. C. BARROSO-TOBILA . L. M. CARBONELL
R. CESPEDES F. . E. W. CHICK . B. M. CLARK· O. DUQUE
G. M. EDINGTON · B. F. FETTER· J. H. GRA HAM · D. J. GUIDRY
R. W. HUNTINGTON, JR . . H. ICHINOSE . G. K. KLINTWORTH
H.1. LURIE· L. N. MOHAPAT!A . J. MORENZ . H. S. NIELSEN, JR.
J. C. PARKER, JR . . C. E. PENA . P. PIZZOLATO · L. POLLAK
K. SALFELDER . ]. SCHWARZ· ]. P. WIERSEMA
H.1. WINNER · D.]. WINSLOW
WITH 796 FIGURES
2 IN COLOR
SPRINGER-VERLAG
BERLIN· HEIDELBERG · NEW YORK
1971
ISBN-13: 978-3-642-80572-1 e-ISBN-13: 978-3-642-80570-7
DOl: 10.1007/978-3-642-80570-7
A special US·edition is available under the title: BAKER. Human Infection with Fungi, Acti
nomycetes and Algae
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is
concerned, specifically those of translation, reprinting, re-use of illustrations, broadcasting, reproduction
by photocopying machine or similar means, and storage in data banks.
Under § 54 of the German Copyright Law where copies are made for other than private use, a fee is payable
to the publisher, the amount of the fee to be determined by agreement with the publisher.
© by Springer Verlag, Berlin-Heidelberg 1971. Library of Congress Catalog Card Number 25-11247.
Soflcovcr reprint of the hardcover 1st edition 1971
The use of general descriptive names, trade names, trade marks, etc. in this publication, even if the former
are not especially identified, is not to be taken as a sign that such names, as nnderstood by the Trade
Marks and Merchandise Marks act, may accordingly be nsed freely by anyone.
HUMAN INFECTION WITH
FUNGI, ACTINOMYCETES
AND ALGAE
BY
ROGER DENIO BAKER
AND
A. ANGULO O .. C. BARROSO-TOBILA . L.M.CARBONELL
R. CESPEDES F. . E. W. CHICK· B. M. CLARK· O. DUQUE
G. M. EDINGTON· B. F. FETTER· J. H. GRAHAM· D. J. GUIDRY
R. W. HUNTINGTON, JR .. H. ICHINOSE . G. K. KLINTWORTH
H. I. LURIE· L. N. MOHAPAT~A . ]. MORENZ . H. S. NIELSEN, JR.
J. C. PARKER, JR .. C. E. PENA . P. PIZZOLATO· L. POLLAK
K. SALFELDER . J. SCHWARZ· J. P. WIERSEMA
H. I. WINNER· D.]. WINSLOW
SPECIAL EDITION OF
HANDBUCH DER SPEZIELLEN PATHOLOGISCHEN
ANATOMIE UND HISTOLOGIE 11115
WITH 796 FIGURES
2 IN COLOR
SPRINGER -VERLAG
NEW YORK· HEIDELBERG· BERLIN
1971
TSBN-13: 978-3-642-80572-1 e-ISBN-13: 978-3-642-80570-7
DOT: 10.1007/978-3-642-80570-7
Special edition of Handbuch der speziellen pathologischen Anatomie und Histologie, Band III/5
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is
concerned, specifically those of translation, reprinting, re-Ilse of illustrations, broadcasting, reproduction
by photocopying machine or similar means, and storage in data banks.
Under § 54 of the German Copyright Law where copies are made for other than private use, a fee is payable
to the publisher, the amount of the fee to he determined by agreement with the publisher_
© by Springer-Verlag, Berlin-Heidelberg 1971 . Library of Congress Catalog Card Number 72 -160 588.
Softcover reprint of the hardcover 1 st edition 1971
The use ofgenerai descriptive names, trade names, trade marks, etc. in this publication, even if the former
are not especially identified, is not to be taken as a sign that such names, as nnderstood by the Trade
Marks and Merchandise Marks act, may accordingly be used freely by anyone.
Preface
Half a century ago our knowledge of mycoses, especially pulmonary mycoses,
was rather fragmentary. It was limited to rare case reports as oddities. Accordingly,
in the "Handbuch der speziellen pathologischen Anatomie und Histologie" the
chapter on lung diseases caused by budding and spore-forming fungi by J. WATJEN
(Halle) took up as little as 27 pages. Only ARNDT (G6ttingen) could report on
several cases from which he made his observations on actinomycotic changes of
the lungs and pleura.
Since then our knowledge of mycoses has deepened and expanded in an unpre
dictable manner. This progress was mainly due to research and publications in the
USA and South America. In Central Europe the number of cases of mycoses has
increased during the last two decades, being reported especially as a second disease
in patients with spontaneous or iatrogenic destruction of the bone marrow after
treatment of cancer with cytostatic agents.
The number of known types of pathogenic fungi has increased. The knowledge
of their types and conditions of growth have given rise to a subspecialty. Therefore,
a great need has arisen for a new edition of the chapter on mycoses in the Henke
Lubarsch-Roessle Handbook of Special Pathological Anatomy and Histology.
The publishers as well as the editors had the great fortune to find as author
Prof. ROGER D. BAKER, who himself has contributed substantially to the know
ledge of human mycoses. It is thanks to Prof. Baker that a large number
of eminent scientists could be won as co-authors. Today, under his guidance,
a complete handbook on human infection with Fungi, Actinomycetes and Algae
has been written. At the present time no other book exists which describes so
extensively the fundamentals of human mycology, including taxonomy, clinical
aspects, epidemiology, and pathological anatomy.
For all the great progress of the past decades we should not forget that 50 years
ago MAX ASKANAZY wrote, for the textbook of General Pathology edited by
LUDWIG ASCHOFF, a substantial and thoughtful chapter on fungi as germs. Among
his illustrations there is a marvelous colorprint of an aspergilloma of the lungs.
This, an early milestone, should not get lost among the abundance of genuine and
supposed newer discoveries.
Zurich/Heidelberg 1971 Prof. Dr. E. UEHLINGER
Contents
List of Authors XV
Introduction. . . XVII
General Chapters (Chapter I-III)
Chapter I: The Scope and General Pathology of Human Infection with Fungi, Actinomy-
cetes, and Algae. R.D. BAKER, New Brunswick, New Jersey, USA
The Causative Organisms . . . . . . . . . . . . . 1
Fungus Diseases . . . . . . . . . . . . . . . . . . . . . . . 2
The Distribution and Epidemiology of Fungus Diseases. . . . . . 2
How Pathogenic Fungi Infect Man. . . . . . . . . . . . . . . 3
Mycoses Associated with Lowered Host Resistance, and Caused by Fungi which are
usually Nonpathogenic and "Opportunistic" . 4
Fungi as Inflammatory Irritants . . . . . 4
Tissue Changes in Fungus Diseases. . . . . . 5
Morbidity and Mortality in Mycotic Disease . . 6
The Demonstration of Fungi in Tissues . . . . 6
Examination for Fungi at Postmortem Examination and in Surgical Specimens 9
Infection by Actinomycetes 10
Infection by Algae 10
References. . . . . . . . 10
Chapter II: Mycology of the Agents Producing Deep Mycoses. J. SCHWARZ, Cincinnati,
Ohio, USA (With 21 Figures). . . . . . . . . . . . 12
Different Mechanisms of Conversion from M to Y Phase 12
Blastomyces Dermatitidis . . . . . . . . 13
Blastomyces (Paracoccidioides) Brasiliensis 17
Histoplasma Capsulatum . 19
Histoplasma Duboisii. . . 23
Sporotrichum Schenckii. . 24
Cryptococcus Neoformans . 27
Candida Albicans. . 29
Coccidioides Immitis 31
Dematiaceous Fungi 34
References. . . . . 36
Chapter III: Ultrastructure of Human Pathogenic Fungi and Their Mycoses. L. M.
CARBONELL, Caracas, Venezuela (With 25 Figures) 38
Introduction. 38
Methods. . . . . 38
Cell Wall . . . . 39
The Cell Contents 45
Developmental Studies 50
Action of Drugs on Fine Structure of Pathogenic Fungi 54
Action of Ultrasound on Pathogenic Fungi 55
Fine Structure of Mycoses ...... 55
Actinomyces, Nocardia and Streptomyces 58
Concluding Remarks 63
References. . . . . . . . . . . . . . 64
The Great Endemic Mycoses (Chapter IV-VII)
Chapter IV: Histoplasmosis. J. SCHWARZ, Cincinnati, Ohio, USA (With 35 Figures) . 67
Definition . 66
History .. 66
Contents VII
Epidemiology . . . . . . . . . . . . . . . 68
Geographic Pathology. . . . . . . . . . . . 68
Mycology ................ . 69
Staining of Histoplasma Capsulatum in Tissues. 71
Pathogenesis . . . . . . . . 75
The Primary Lesion in the Lung 79
Histoplasmoma . . . . . 84
Cavitary Histoplasmosis . 87
"Epidemic" Histoplasmosis 90
The Spleen ...... . 92
The Liver ....... . 95
Bone-Marrow, Bone and Joints 95
Lymph Nodes . . . . . . . . 98
Lymphoma and Histoplasmosis 102
Heart and Mediastinum . . . . 103
Interpretation of Indirect Diagnostic Methods 105
Adrenals ......... . 107
Mucocutaneous Histoplasmosis 109
Larynx ....... . III
Gastrointestinal Tract 112
Genitourinary System. . 115
Brain, Meninges and Eye 116
Associated Diseases. 119
References. . . 121
Chapter V, Part 1: African Histoplasmosis. G.M. EDINGTON, Ibadan, Nigeria (With
1 Figure) 131
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Chapter V, Part 2: African Histoplasmosis. J. SCHWARZ, Cincinnati, Ohio, USA (With
4 Figures) . . . . . . . . . . . . . . 139
Geography . . . . . . . . . . . . . . 139
The Organism H. Duboisii Vanbreuseghem 139
References. . . . . . . . . . . . . . . 145
Chapter VI: Coccidioidomycosis. R. W. HUNTINGTON, Jr., Bakersfield, California, USA
(With 36 Figures) 147
I. Definition, Synonomy . . . . . 147
II. History . . . . . . . . . . . 150
a) Clinical and Pathologic Studies 150
b) Character and Ecology of the Organism 161
III. Biology . . . . 167
a) The Fungus . . . . 167
b) The Infection 170
IV. Geographical Pathology 172
V. Diagnosis . . . . 174
a) Skin Tests . . . 175
b) Serologic Studies 176
c) Wet Mounts. . 177
d) Cultures. . . . 178
VI. Pathologic Anatomy. 179
a) Basic Pathologic Processes 179
b) Sources of Material . . . . 181
c) Lesions in Fatal Coccidioidomycosis. 183
VII. Categories of Grave and Fatal Coccidioidomycosis 187
VIII. Demonstration of Coccidioides in Tissue Sections 199
Mycelial Phase - C. Immitis in Tissue 201
References. . . . . . . . . . . . . . . . . . . . 202
VIII Contents
Chapter VII: Dermal Pathology of Superficial Fungus Infections. J. H. GRAHAM, Irvine,
California, USA, and C. BARRoso·ToBILA, Maracaibo, Venezuela (With 156 Figures) 211
Introduction. . . . . 211
Material and Methods. 212
Tinea Capitis 214
1. Introduction 214
2. Microsporum Audouinii and Microsporum Canis 215
3. Microsporum Gypseum . . . . . . . . . . . 230
4. Trichophyton Schoenleinii ......... 233
5. Trichophyton Mentagrophytes . . . . . . . . 239
6. Trichophyton Tonsurans and Trichophyton Sulfureum 243
7. Trichophyton Violaceum . . . . . . . . . . . . . 252
8. Summary and Conclusions . . . . . . . . . . . . 256
Tinea Barbae, Tinea Faciei, Tinea Corporis, Tinea Manuum, Tinea Cruris, Tinea Pedis
and Tinea Unguium. . . . 257
1. Introduction .. . . . . . 257
2. Trichophyton Rubrum . . . 258
3. Trichophyton Mentagrophytes 292
4. Trichophyton Verrucosum. . 304
5. Trichophyton Violaceum . . 308
6. Trichophyton Concentricum . 310
7. Trichophyton Tonsurans and Trichophyton Sulfureum 313
8. Trichophyton Epilans. . . . . . . . . . . . 315
9. Microsporum Audouinii and Microsporum Canis 321
10. Microsporum Gypseum . . . 325
11. Epidermophyton Floccosum . 332
Cutaneous Candidiasis. . 335
Tinea Versicolor . . . . 342
Pityrosporum Folliculitis 347
Tinea Nigra 352
Piedra . . 359
Erythrasma 370
References. 377
Infections by Fungi That Are Commonly Primary Pathogens (Chapter VIII-XV)
Chapter VIII: Cryptococcosis. K. SALFELDER, Merida, Venezuela (With 68 Figures) 383
Definition . 383
History. . . . . . 384
Incidence . . . . . 385
Associated Diseases 388
Epidemiology 390
Mycology . . . . . 393
Pathogenesis 401
Pathology 405
Diagnosis and Differential Diagnosis 436
Clinical Aspects 439
Animals. . 441
References. . . 445
Chapter IX: North American Blastomycosis. E.W. CHICK, Lexington, Kentucky, USA
(With 40 Figures) 465
Definition. . . . . . . . . . 465
Epidemiology . . . . . . . . 466
a) Geographical Distribution 466
a) Cases from North America (USA and Canada) 466
fi) Cases outside North America 466
b) Age Distribution . 466
c) Sex Distribution . 468
d) Racial Distribution 468
e) Occupation 468
Contents IX
f) Epidemics . . . . . . . . . . 469
g) Natural Occurrence of Organism 470
Mycology . . . . . . . . . . 470
a) Cultural Characteristics 470
p) Clinical Specimens . . 474
y) Animal Inoculation. . 475
Pathogenesis and Immunology. 475
Pathology. . . . . . . 476
a) General Pathology 476
b) Special Pathology 479
Lung . . . . . . . 479
Skin. . . . . . . . 481
Bone . . . . . . . 485
Genitourinary Tract . 486
Liver and Spleen . . 491
Other Organs. . . . 493
Central Nervous System 497
Clinical Features 500
Therapy. . . 502
References. . . . . 503
Chapter X: Paracoccidioidomycosis. A. ANGULO 0., and L. POLLAK, Caracas, Vene-
zuela (With 70 Figures) . 507
History. . . . 507
Etiology . . . 507
Epidemiology . 511
Portal of Entry 513
Histopathology 514
Clinical Forms . 523
Mucocutaneous Lesions 525
a) Mucosal Lesions. 527
b) Cutaneous Lesions. 529
Pulmonary Lesions. . . 531
Lesions of Lymph Nodes 542
Lesions of the Spleen. . 543
Lesions of the Nervous System. 545
Lesions of the Cardiovascular System . 545
Lesions of the Digestive System . 547
Hepatic Lesions . . . . . . 550
Pancreatic Lesions . . . . . 551
Lesions of Endocrine Glands . 551
Urinary Tract . . . . . . . 554
Lesions of the Genital System 554
Osteoarticular Lesions. . . . 555
Paracoccidioidomycosis in Association with other Diseases 556
Immunology 557
Laboratory Tests 557
Treatment . 558
References. . . . 560
Chapter XI: Lobo's Disease (Keloidal Blastomycosis). J.P. WIERSEMA, Washington,
D.C., USA (With 13 Figures) . . . 577
Definition. . . . . . . . . . . . . . . . . . . 577
History. . . . . . . . . . . . . . . . . . . . 577
Geographical Distribution, Incidence, Epidemiology 577
Clinical Picture. . . . 578
Macroscopic Pathology 580
Microscopic Pathology 581
Mycology . . . . . . 585
Differential Diagnosis . 588
References. . . . . . 588