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Bentonite particles uncoated and coated with soluble antigen of Paracoccidioides brasiliensis (Pb) were intravenously injected into mice with and without previous immunization with Pb antigen. The inflammatory reaction around the bentonite emboli in small lung vessels was quantitated and morphologically studied by light and electron (EM) microscopy, 2 to 8 days after challenge. In control nonimmunized animals, coated and uncoated bentonite particles caused mild and nonspecific inflammation made up by macrophages. By EM, they formed loosely aggregated clusters with cytoplasm containing few organelles and borders without interdigitation. In immunized mice injected with coated bentonite particles, the inflammatory area was significantly greater than that in nonimmunized animals in all periods of study with maximum difference at day 2. The inflammatory process at days 2 and 4 was characterized as mature granulomata, composed of macrophages with great number of organelles in the cytoplasm, large euchromatic nuclei and prominent nucleoli. Altogether these findings indicated a lesion with high metabolic activity, compatible with a granulomatous hypersensitivity reaction. At days 6 and 8, there was a change from mature to epithelioid granulomata, well demonstrated by EM which showed macrophages with characteristically interdigitated cytoplasmic borders. The results strengthen the importance of cellular immunity in the genesis of epithelioid granuloma in paracoccidioidomycosis and reinforce the usefullness of the present model in studies of the inflammatory cellular sequency and events in this mycosis. [ABSTRACT FROM AUTHOR]

Two patients with co-existing meningeal and pulmonary cryptococcosis were successfully treated by pulmonary resection and chemotherapy. Under cover of miconazole and 5-fluorocytosine, pulmonary mass lesions were successfully removed despite the fact that the patients had meningitis. The patients recovered from meningitis immediately after the surgical procedures and show no recurrence of meningeal symptoms more than 2 years after the operation. It appears that early removal of a pulmonary cryptococcal focus combined with antifungal agents may give a quite favourable outcome for meningitis. [ABSTRACT FROM AUTHOR]