. The American journal of tropical medicine. rths fluid or Zenkers, although the latter when deep hema-toxylin stain is used seems to give the best picture. Diagnosis: Blastomycotic granulomata of the lung. Kidney. No increase in the intertubular connective tissue, slightincrease in the thickness of the Capsule of Bowman, Glomerules arefilled with blood and there is some excess of blood in the adjacentvessels. The epithelium of the convoluted tubules is swollen, fused,granular, frayed, nuclei too few or too pale, seeming to take the redstain at times somewhat. Occasionallv in the tubules fine
. The American journal of tropical medicine. rths fluid or Zenkers, although the latter when deep hema-toxylin stain is used seems to give the best picture. Diagnosis: Blastomycotic granulomata of the lung. Kidney. No increase in the intertubular connective tissue, slightincrease in the thickness of the Capsule of Bowman, Glomerules arefilled with blood and there is some excess of blood in the adjacentvessels. The epithelium of the convoluted tubules is swollen, fused,granular, frayed, nuclei too few or too pale, seeming to take the redstain at times somewhat. Occasionallv in the tubules fine vacuoles are SYSTEMIC BLASTOMYCOSIS 129 found which are not infrequently lined up toward the basement mem-brane. The lumens of the tubules are often fused shut, but at timesclosed up with granular debris. As one approaches the medulla thesefeatures change somewhat. There is much infiltration of the intertu-bular connective tissue wdth small lymphocytes, the epithelia show afair amount of vacuolation of the cytoplasm, although the nuclei re-. FiG. 3. Radiating Bbanched Hyphae; Young Colonies ox Agar Plate main they are somewhat distorted in shape by shrinkage. Occasionallytube casts are found. No evidence of blastomyces are found. Diagnosis: Acute interstitial nephritis with distinct fatty change. The character of this illness was suggested by a previous caseof local blastomycosis with a similar verrucous growth in multipleform on the head of a patient of one of my surgical colleagues 130 M. L. GRAVES about 1910. This case was purely local and was cured by surgi-cal means. The papillomatous growth in the forehead of mypatient, designated by him as a seed wart, was to superficialappearances the same sort of growth as that of the case of 1910. Our premortem diagnosis was blastomycosis, systemic infection,septic pneumonia right and left lungs, acute nephritis. In the light of the post-mortem examination we felt somewhathumilated that the recognition of the pneumonic areas in thelun
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Keywords: ., bookcentury1900, bookdecade1920, booksubjecttropica, bookyear1921
