[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.

[Familial translocation 3/22 MAT with partial trisomy 3q (author's transl)]

Two mentally retarded brothers with partial trisomy 3q show clinically similar malformations and deformities : dwarfism, bushy eyebrows, eversion of the nostrils, low inserted ears, high palate, microgeny, low hair insertion, short and broad hands with proximally inserted thumbs, clinodactylia of the 5th finger, syndactylies, mostly arch patterns on the digital pulps, muscular hypotonia, joint relaxation and cryptorchism. Both children had fits of convulsions. The younger boy showed, moreover, a perception deafness. The mother, the maternal grand-mother as well as the phenotypically normal sister of the patients revealed a balanced translocation 3/22 with a karyotype : 46,XX,t(3;22) (q25;p11).

[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.

Staphylococcus aureus and Candida albicans infection (animal experiments)

During a certain period of the course of infection in white mice inoculated intraperitoneally with the pure culture of a proteolysing strain of Candida albicans, Staphylococcus aureus and C. albicans both, were isolated simultaneously from the peritoneal abscesses, especially those adhering to the stomach, duodenum, pancreas and the upper part of small intestine. This concommitant occurrence of the two pathogens was further corroborated by histopathological examination which revealed large number of staphylococci present in the close neighbourhood of Candida cells, usually in the center of the granulomata caused by the fungus. In view of the facts that the proteolytic end-products of C. albicans can offer a good substratum for the growth of S. aureus and the latter may be isolated from the intestinal tract of apparently healthy mice, possibly as a constituent of the transient microflora, the co-existence of these two important aetiologic agents of endogenous infections as encountered during this study appears to be of great clinical interest. Furthermore, these observations also demonstrate the importance of controlling the bacterial flora of mice for pure mycological studies.

[Intraocular cryptococcosis (author's transl)]

A 79-year-old female patient suffered from iridocyclitis of both eyes. In the fundus of the left eye equatorially a preretinal questionable granuloma (size 1/2 d.d.) was found; the first hint of a mycotic involvement. In the enucleated right bulbus, an abscess-like granulomatous focus with a diameter of 10 mm was found. Several round encapsulated cells having a diameter of 7 to 20 mu and looking like with Cryptococcus neoformans were microscopically demonstrable in the pus obtained from this abscess. Since the fungus could not be cultured, it may be assumed that a spontaneous healing occurred. The only known basic disease was a temporary uremia (330 mg0/0 urea and 7.0 mg0/0 creatinin). The role of amphotericin B therapy in this patient is discussed.

Selective involvement of the brain in experimental murine cryptococcosis. II. Histopathological observations

In the present communication the previously described cultural findings about the selective involvement of the central nervous system by C. neoformans, strain W 2/A 94, have been supplemented by the results of histopathological investigations. Attention has been paid to the organ specific tissue reaction during the course of infection, with special reference to the involvement of the brain. In agreement with former observations concerning the cryptococcoma in the muscle-tissue, the cryptococcal foci in the brain also showed the phenomenon of vascularisation. The results have been compared with those of the C. neoformans, strain W 71/A 117 which does not allow such a prolonged selective involvement of the central nervous system due to its high virulence for the white mice. These observations impressively demonstrate the significance of simultaneous microbiological and histopathological examinations for the detection of infections caused by such facultative pathogens.

Partial monosomy 13 as the result of a balanced translocation 3/13 pat

In a 4 1/3-year old girl we found the karyotype 45, XX, del13(pter yields q12). The father showed a balanced translocation 3/13 (karyotype: 46,XY,t(3;13) (p27;q12). Psychological investigation of the patient revealed almost normal intelligence (DQ91). Clinical symptoms were: low birth weight, growth retardation, dolichocephalus, microgenia, antimongoloid slant of the eyes, edema on hands and feet, strabismus convergens, clubfoot (left), slight decrease in IgA and IgM.