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Derived from a Greek word meaning fungus, mycosis may take many forms. The term has been used to indicate any disease caused by microbes. In modern medicine the name is usually applied to mycosis fungoides only, although by some authors fungus infections generally are referred to as the group of mycoses; e.g. mycosis cutis chronica, mycosis framboesioide (yaws), Gilchrist's mycosis, mycosis intestinalis.
Mycosis Fungoides
The name mycosis fungoides was applied by reason of the clinical appearancc of this disease and not as a description of its cause, which is still quite unknown. The commonest age of onset is between forty and fifty, males being more frequently attacked. Few cases of recovery have been noted, whilst the duration of ihc disease varies from two months to ten years.
There are two types; in the first there is an insidious onset with an apparently innocent eruption which is followed by tumour formation; the second variety differs from the first only in the omission of the early stage.
The early pre-mycotic lesions consist of dull red patches, which vary considerably in size and may be slightly raised above the surrounding epidermis. They are almost
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Left, portion of the mycelium, or network, and stalks carrying spores of a member of the aspergillus genus of fungus. Right, growth within a bronchial tube causing inflammation; besides bronchitis, the lung may be involved, giving rise to symptoms or broncho-pneumonia or suggestive of consumption.
characteristic in that they assume discoid and circular formations, frequently enclosing an area of apparently normal skin, as well as a slight but definitely palpable infiltration, there is scurfiness of the scaly and an intense itching which is not relieved by treatment. This stage may last for years, but ultimately some of the patches grow into actual tumours. These are rounded and have a slightly depressed centre, being somewhat soft to the touch. They increase in numbers and may be situated all over the body, attacking the face in particular. Some disappear spontaneously, but the majority enlarge and finally ulcerate. Infection with the pyogenic organisms now occurs, and the severe intoxication soon results in exhaustion and death.
The X-rays provide the best treatment, but they are only ameliorative and not curative. Surgical excision and diathermy have been used to remove particularly large or inconvenient growths more rapidly. Quinine, too. has met with a certain amount of success.
True Mycotic Infections
There are certain minute fungi known as the higher bacterial yeasts, filamented growths which are cut by septa into short rod-like elements called hyphae. Certain threads are set apart for purposes of reproduction, and on these the spores are formed.
There are various classes, the chief species being the leptothrices, cladothrices and streptothrices. All are of importance in that some of their members can infect man either internally or externally. They thus give rise to a true mycotic series of diseases, some of which are described below.
Mycosis leptothrica is a chronic infection of the tonsils with a mould called the leptothrix buccalis Syn: trichomycosis axillaris). The symptoms are those of a chronic tonsillitis, and on examination of the throat there are seen small hard white patches dotted over the tonsils. They are extremely diificult to detach. Occasionally the fungus spreads to involve the pharynx and the insides of the cheeks.
In actinomycosis (q.v. ) the parasitie organism is the ray fungus, a species of streptothrix. Nocardiasis is but another form of streptothrix which may invade the lungs or result in multiple abscesses, some of which occur in the brain. It is a very rare condition.
Aspergillosis (q.v.) in man is a rare disease. Although widely distributed in nature it is mostly present as a harmless parasite, but in birds, cattle, and dogs it often produces lesions similar to those found in man. Apparently by inhalation of spores, the fungus reaches the lungs, and, developing there, gives rise to conditions resembling broncho-pneumonia or chronic pulmonary tuberculosis. Treatment is as for the latter complaint, the outlook being usually bad.
The black aspergillus niger is oceasionally found in the external ear, where it gives rise to a chronic pustular inflammation of the skin. It may also invade the nose, throat and cornea.
Oidiomycosis, also called blastomycosis and saccharomycosis, is a rare condition in which the fungus gives rise to a chronic ulcerating and pustular skin infection.
Sporotrichosis is also uncommon. There may be hard nodules lying just under the skin, and these break down to form abscesses. Other types result in ulcers and masses in the muscles or bones.
Thrush and madura foot are yet other varieties of mycosis. For an account of the symptoms to which they give rise reference should be made to those headings.
Mycosis intestinalis
gastroenteric form of anthrax (q.v.), the symptoms of which are those of gastroenteritis followed by toxemia and general depression.