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Gymnothecia with asci and ascospores developed repeatedly and in abundance whenever Trichophyton quinckeanum isolates X-392 and IMI 140691 were paired with Arthroderma simii 678 A. However, repeatable fertile crosses did not occur when all of our 19 isolates of T. quinckeanum were paired with 10 other isolates of A. simii comprising A and a mating types. Additional crosses between these 19 isolates of T. quinckeanum with A. simii and with A. benhamiae revealed that 11 of the 19 isolates of T. quinckeanum produced fertile gymnothecia only when crossed with A. simii 678 A but not when crossed with another isolate of A. simii of the A mating type nor when crossed with mating type a. All 19 isolates mated with A. benhamiae mating type A; therefore, all of our T. quinckeanum isolates were of the a mating type. Study of asci and random ascospores, selected with a micromanipulator, from crosses between several isolates of T. quinckeanum and A. simii 678 A revealed irregularities in the maturation of ascospores, poor ascospore germination, and a predominance of the A. simii phenotype and mating type for those ascospores that germinated and produced mature colonies. All these reactions are characteristic of interspecific crosses. In contrast, ascus analysis of the F1 progeny of crosses between these same isolates of T. quinckeanum with A. benhamiae revealed regular maturation of ascospores, better germination, and essentially a 1:1 segregation of mating types and parental phenotypes. This study confirms the concept that T. quinckeanum is not an independent species and that it is best considered to be a variety of T. mentagrophytes, as reported by Ajello, Bostick & Cheng (1968). Furthermore, our data indicate that T. mentagrophytes var. quinckeanum appears to be more closely related to A. simii than the granular variety of T. mentagrophytes, since fertile gymnothecia resulted from crosses between T. mentagrophytes var. quinckeanum and A. simii but not between T. mentagrophytes var. mentagrophytes and A. simii. Further implications of this study suggest the importance of extensive ascospore analysis when investigating the perfect states of fungi in order to avoid creating unwarranted new species.

A 61-year-old renal transplant recipient developed a subcutaneous leg abscess caused by Phialophora parasitica. Treatment with fluconazole resulted in no improvement after 18 weeks. The abscess required excision for cure. This phaeohyphomycotic infection due to P. parasitica represents the fourth case in a renal transplant recipient described in the literature.

Exoantigen tests for the immunoidentification of fungal pathogens are playing a new and significant role in the diagnostic laboratory. Properly performed and controlled exoantigen tests lead to rapid, accurate identification of cultures of many fungal pathogens. The tests are particularly valuable in identifying dimorphic pathogens that are difficult to convert or with atypical cultures. We review the value of exoantigen tests for identifying mycelial form fungi: Aspergillus spp. Blastomyces dermatitidis, Coccidioides immitis, Exophiala jeanselmei, Histoplasma spp., Paracoccidioides brasiliensis, Penicillium marneffei, Pseudallescheria boydii, Sporothrix schenckii, Wangiella dermatitidis and certain dermatophytes. We discuss procedures for performing the tests and sources of error.

We identified Exophiala spinifera as the causal agent in a case of subcutaneous phaeohyphomycosis in El Salvador. Identification was based on the morphology of the fungus in tissue and the microscopic features of the culture obtained from the biopsy material. This case is the first of this type to be documented from Central America.

We evaluated the diagnostic value of antibody to Blastomyces dermatitidis A precipitin arcs for identifying B. dermatitidis cultures by the exoantigen technique with 88 isolates from the United States and Canada, 12 from Africa, and 1 each from India and Israel. In addition, we studied 190 mycelial-form isolates of other fungi which could be confused antigenically or morphologically with B. dermatitidis. Antigen extracts from all of the North American isolates, the Indian and Israeli isolates, and one of the African isolates reacted with the B. dermatitidis A antibody. The anti-A serum did not react with antigens from the other 11 African isolates or with antigens from any of the 190 heterologous fungi. Studies with unadsorbed and adsorbed antisera to selected North American and African isolates of B. dermatitidis showed that the North American isolates not only produced the distinct A antigen, but also formed another antigen that was common to all 11 of the antigenically less complex African isolates. The results of this study indicate that at least two serotypes of B. dermatitidis exist. All of the North American, Indian, and Israeli isolates and one of the African isolates contained the A antigen and were designated serotype 1. Most of the African isolates (11 of 12) constituted a second serotype that was deficient in A but showed an antigen designated K.

The first case of subcutaneous zygomycotic infection caused by Saksenaea vasiformis in a rice mill worker from India is described. The infection, confined to the man's left foot, showed multiple draining sinuses, inflammation, and intermittent low-grade fever following a crushing injury when a log fell on his foot. Histopathologic examination of two biopsy specimens, taken at 3-wk intervals, revealed the presence of broad, sparsely septate, branched, hyaline hyphae characteristic of a zygomycete. When they were grown on a nutritionally deficient medium, two cultures isolated from the biopsied tissues formed numerous, vase-shaped sporangia typical of S. vasiformis. Necrosis of the affected area led to amputation of the fore part of the foot. A split thickness graft was well accepted, and treatment with potassium iodide, following the graft, cured the infection.

A bilateral nasal phaeohyphomycotic infection caused by Bipolaris hawaiiensis in an immunocompromised woman from India is described. Repeated direct microscopic examinations of the nasal scrapings revealed the presence of septate, branched, pigmented hyphal fragments intermingled with cells that divided internally by one transverse septum and a few cells that were chestnut brown dividing internally by septa in different planes to become muriform. Cultures of the scrapings yielded B. hawaiiensis. Local excision of the crusted lesion followed by application of 0.03% nystatin solution four times a day for 3 weeks cured the infection.

A rare case of primary cerebral zygomycosis in an Italian drug addict is described. The diagnosis was based on the histologic detection of broad, aseptate, hyaline mycelium in fluid aspirated from a brain mass detected by computerized axial tomography. The zygomycete isolated from the clinical specimen was identified as Rhizopus arrhizus var arrhizus. The patient had no known predisposing condition that would have suppressed his immunological defenses. Once the diagnosis was established, treatment with amphotericin B was initiated, but the patient died during the first day of treatment.

A 26-year-old woman from Grand Cayman Island with a 3-month history of a lump in the left breast was presumptively diagnosed as having a carcinoma. A segmental resection was attempted. Histologic examination of the biopsied tissue showed extensive granulomatous inflammation, necrosis, and septate, branched, dematiaceous hyphae in the intralobular ducts as well as in the surrounding tissues. When cultured on Sabouraud dextrose and brain heart infusion agars, the tissue yielded a slow-growing, downy, dematiaceous mould. Microscopically, it produced short, branched and unbranched chains of holoblastic conidia in acropetal manner from erect conidiophores that were characteristic of the genus Cladosporium. The isolate grew well at 36-37 degrees C, but failed to grow above 37 degrees C. It did not liquefy gelatin nor decompose casein, xanthine, hypoxanthine, or tyrosine, but did hydrolyze urea. Comparative studies with other pathogenic and saprophytic species of Cladosporium revealed that it represented an undescribed species. It is named Cladosporium devriesii, sp. nov.

A case of zygomycosis caused by Apophysomyces elegans in a diabetic, obese female is described. The fungus gained entry into the body through injury to the skin, penetrating the keratin, epidermis, and dermis. Hyphal angioinvasion was observed. Fungal elements invaded the subcutaneous fat, skeletal muscle fibers, nerves, and large blood vessels, resulting in the spread of the infection. The rapidity with which A. elegans invaded the blood vessels left no choice except amputation of the leg to stop the spread of the infection. This zygomycetous fungus closely resembles Absidia corymbifera. It is distinguished by its prominent campanulate apophyses. In its gross colony characteristics and failure to sporulate on routinely used media it resembles Saksenaea vasiformis.

A newly developed commercial serological test (Iatron Laboratories, Inc., Tokyo, Japan) for the rapid identification of medically important species of Candida was evaluated against the API 20C (Analytab Products, Plainview, N.Y.) and the standard Wickerham assimilation and fermentation procedures. Our results indicated that the Iatron and the API 20C methods are 95% accurate since both permitted identification of 78 of 82 Candida isolates, representing eight medically important species. None of the tests on nine Cryptococcus, six Trichosporon, three Geotrichum, three Saccharomyces, and one Rhodotorula species yielded false-positive reactions. False-positive serological tests occurred with a species of Pichia and Candida rugosa. The API 20C procedure correctly identified C. rugosa but not the Pichia sp. The Iatron method permitted reliable identification of the Candida species in 10 min to 5 h, whereas the API 20C procedure required 48 to 72 h. Neither method could properly identify sucrose-negative Candida tropicalis or Candida lusitaniae isolates. In addition, Candida albicans isolates could be serotyped by the Iatron method.

A 32-year-old male patient developed headaches, vomiting, blurring of vision, and focal seizures of the left side of the face 2 months after a renal transplant. He developed a brain abscess and died. Direct KOH examination of the brain tissue demonstrated hyaline as well as dematiaceous, septate hyphae. Histologic examination of brain sections revealed polymorphous fungal elements consisting of septate, dark-pigmented hyphae, intercalary and terminal swollen fungal cells, and budding yeastlike cells characteristic of phaeohyphomycosis. Chaetomium globosum was isolated from the brain tissue on all of the fungal media used. This case represents the first histologically and culturally documented phaeohyphomycotic brain infection caused by C. globosum.

One hundred and ninety-eight isolates of Microsporum canis, obtained from humans and animals in 12 countries, were paired with the two Japanese tester strains of Nannizzia otae (= M. canis), VUT 74037 (CDC B-2094+) and VUT 74039 (CDC B-2095-). One hundred and forty-one (72%) produced either gymnothecia or pseudogymnothecia in crosses with VUT 74037. Fifty-seven (28%) were nonreactive. None of the paired isolates reacted with VUT 74039. The number of nonreactive isolates decreased to 17% when 104 of the 198 isolates were paired with one additional tester strain of each mating type. All sexually reacting strains, however, belonged to the (-) mating type. Crosses between nonreactive isolates did not result in ascocarp formation. The F1 generations from three different strongly reactive crosses were all characterized by poor ascospore germination. Most of the monoascospore progeny that germinated to form mature colonies were nonreactive in crosses to determine their mating type. Others reacted predominantly as the (+) mating type, thereby precluding the likelihood of an associated lethal factor accounting for the lack of this mating type in our clinical isolates. Several explanations for this phenomenon are presented.

Keratinomyces ceretanicus was described as a new taxon distinct from Trichophyton ajelloi. Because of the morphological similarity between the two species, their mating behaviour was studied. The optimum temperature for growth of K. ceretanicus was found to be 25 degrees C rather than 17 degrees C. The type culture produced moderate numbers of microconidia on potato glucose agar after 2 weeks at 25 degrees C and a large number of smooth, thick-walled, cylindro-fusiform, 7-to 12-celled macroconidia. On Sabouraud glucose agar containing chloramphenicol and cycloheximide growth was partially but not completely inhibited. When crossed on a soil-hair medium, K. ceretanicus produced fertile gymnothecia typical of Arthroderma uncinatum with 10 (-) mating type isolates of A. uncinatum. As a result, it is concluded that K. ceretanicus is a facultative synonym of T. ajelloi.

Pythium insidiosum sp. nov., the etiologic agent of pythiosis, a cosmopolitan disease of horses, cattle, and dogs, is described and illustrated.

A 27-year-old man with a 6-year history of allergies developed nasal polyps that occluded his nose and prevented visual examination beyond the nasal vestibules. Histological examination of the polyps and bony tissue revealed septate, dematiaceous hyphae invading the bone trabeculae. A dematiaceous fungus was isolated in pure culture from the diseased tissue. Detailed mycological examination of the isolate showed that it produced numerous, distinctive poroconidia from erect, geniculate, sympodial conidiophores. The conidia were straight and cylindroellipsoidal, had 8 to 13 distosepta, and had protruding hila. The outer cell walls of the conidia, which were initially smooth, became unevenly roughened on aging. Comparison with other Exserohilum species revealed that the isolate represented an undescribed species; it is named Exserohilum mcginnisii sp. nov.

Penicillium marneffei (ATCC 24100) was first isolated from a naturally acquired human infection in the U.S.A. by DiSalvo et al. in 1973. In 1979, this isolate was studied by Pitt who reidentified it as Penicillium primulinum. This prompted us to examine the antigenic relationship between P. marneffei and P. primulinum by comparing their exoantigens. The antigenic relationships of 11 isolates, including the type strains of P. marneffei and P. primulinum, were examined. Each exoantigen extract was tested simultaneously against rabbit anti-P. marneffei and P. primulinum antisera in the presence of the appropriate reference antigens. All eight isolates of P. marneffei, including ATCC 24100, produced two to four specific precipitin lines against their homologous antiserum. However, four of the eight extracts cross-reacted with unabsorbed antiserum to P. primulinum. The P. primulinum extracts contained specific exoantigens which only reacted with the anti-P. primulinum antiserum. Non-specific cross-reactions were eliminated by absorption procedures. On the basis of the specific exoantigens produced by both species, P. marneffei and P. primulinum were found to be antigenically distinct. Isolate ATCC 24100 was shown to be closely related to the other P. marneffei isolates and distinct from P. primulinum. Our results confirm the original identification of ATCC 24100 as P. marneffei and not P. primulinum as Pitt had concluded.

The first two cases of Penicillium marneffei infection in humans were reported in 1959 and 1973. There had been no additional clinical reports of penicilliosis marneffei, until the five new cases of human infection described in this paper, the first from Thailand. The patients, three of whom died, came from various parts of the country. Their common clinical manifestations were fever and generalized lymphadenopathy, with multiple soft tissue, bone, joint and pulmonary involvement. Pericarditis with effusion was also seen. The diagnosis was established by isolating and identifying a dimorphic Penicillium species that produced a soluble red pigment in its mycelial form. The histopathologic features of the lymph nodes and bone marrow were similar to those of histoplasmosis capsulati. However, the yeast-like tissue form of P. marneffei divides by fission; that of Histoplasma capsulatum by budding. Treatment with amphotericin B was effective when this antifungal antibiotic was administered early in the course of the disease.

During the period September 1983 through May 1985, Candida parapsilosis was isolated from intravascular sites (blood or vascular catheter tips) in 12 patients at a pediatric hospital. Of 205 patients with cultures of any site positive for Candida species, 32 (16%) had cultures positive for C. parapsilosis. In contrast, of 23 patients with intravascular cultures positive for Candida species, 12 (51%) had cultures positive for C. parapsilosis (P less than 0.001, Fisher's exact test). The 12 patients with intravascular cultures positive for C. parapsilosis were more likely to have received central venous nutrition therapy (10 of 12 versus 7 of 23; P less than 0.01, Mantel-Haenzel chi-square test) and had a longer duration of exposure to blood pressure transducers (P less than 0.08, paired t test) than the 23 ward- and age-matched controls. C. parapsilosis was isolated from 11 (32%) of 34 in-use and stored blood pressure transducers. After ethylene oxide sterilization of blood pressure transducers was begun, in-use pressure transducers showed no growth of C. parapsilosis. This study emphasizes the role of C. parapsilosis as a nosocomial pathogen associated with invasive devices and parenteral nutrition; it also emphasizes the importance of adhering to recommended procedures for sterilizing blood pressure transducers.

A slowly evolving subcutaneous mycosis in a 10-year-old domestic shorthair cat was found to be caused by Drechslera spicifera, the imperfect state of ascomycete Cochliobolus spicifer. The cat had circular, nodular, granulomatous lesions over its sternum. Scattered individual and small groups of septate hyphae and chlamydospores were found in histologic sections. Many of the hyphae also had bizarre dilatations. Most of the fungal elements were hyaline; a few, however, were dematiacious. Because the fungus was not organized into granules in tissue, the disease could not be classified as a mycetoma. The preferred name for infections of this type is phaeohyphomycosis.

It is concluded that the validly published genera Candida and Torulopsis are taxonomically distinct. The recently proposed merger of these two yeast genera is rejected.

The second human subcutaneous infection due to Exophiala spinifera from the United States is described. Identification was based on the morphology of the fungus in tissue and the morphological features of the culture obtained from the biopsy material. Correct diagnosis and treatment with ketoconazole and 5-fluorocytosine cured the infection.

The conventional auxanographic method of testing for the assimilation of carbohydrates and alcohols by the various species of Prototheca requires at least 2 weeks of incubation at 25 to 30 degrees C before definitive results are obtained. Even though Prototheca spp., in culture as well as in fixed tissues, can be identified more rapidly by fluorescent-antibody techniques in which species-specific reagents are used, such diagnostic facilities and reagents are not available in most diagnostic laboratories. The API 20C clinical yeast identification system, a commercially available ready-to-use micromethod, was found to permit the definitive identification of P. stagnora, P. wickerhamii, and P. zopfii within 4 days.

A variety of diagnostic tests used by many laboratories to identify isolates of Wangiella dermatitidis (= Fonsecaea dermatitidis) were evaluated. Thirteeen isolates of W. dermatitidis were studied with respect to their ability to grow at 25, 37, 40, 45, and 50 degrees C, colonial and micromorphology, gelatin liquefaction, and hydrolysis of casein, xanthine, hypoxanthine, and tyrosine. All 13 isolates showed growth at 25, 37, and 40 degrees C but failed to grow at higher temperatures. The ability of W. dermatitidis to grow at 40 degrees C can be useful in its identification.

It is proposed that the dematiaceous hyphomycete Cladosporium bantianum (Saccardo) Borelli be transferred to the genus Xylohypha (Fries) Mason as Xylohypha bantiana (Saccardo) McGinnis, Padhye, Borelli, et Ajello. This new combination is necessary because X. bantiana produces conidiophores that are indistinguishable from its vegetative hyphae and one-celled, smooth-walled conidia that are borne in long, infrequently branched chains. The blastoconidia do not possess darkly pigmented hila. In contrast, members of the genus Cladosporium Link produce erect, distinct conidiophores and one- to four-celled smooth-to-rough-walled conidia that occur in short, frequently branched, fragile chains. The blastoconidia have darkly pigmented hila. Cladosporium trichoides Emmons is a later synonym of X. bantiana.

Acremonium recifei was identified as the causal agent in a case of white grain eumycotic mycetoma of the hand which occurred in South India. The identification was based on the structure of the granules in tissue and on the morphological characteristics of the culture obtained from the granules. This case represents the first documented instance in which A. recifei has been found outside of Latin America.

Phaeoannellomyces werneckii is identified on the basis of its annellidic conidiogenous cells and the production of two-celled conidia. Without the proper recognition of its annellidic mode of conidiogenesis, isolates of P. werneckii can be confused with other species of Phaeococcomyces, Exophiala, and Scolecobasidium constrictum. To overcome this problem, we developed exoantigen reagents capable of specifically identifying P. werneckii. Rabbit P. werneckii antiserum was rendered specific by adsorptions with antigens of Exophiala jeanselmei serotype 1, Exophiala moniliae, and Wangiella dermatitidis. Eighty-two dematiaceous yeast-like fungi, including 18 P. werneckii cultures, were tested in the immunodiffusion test against P. werneckii antisera. Exoantigen tests permitted the rapid and specific identification of the 18 P. werneckii isolates. Negative results were obtained with the 64 heterologous antigen extracts.

A fatal rhinocerebral zygomycotic infection caused by Saksenaea vasiformis in a 71-year-old man was diagnosed based on the presence of broad, infrequently septate, branched, hyaline hyphae in tissue obtained from the right and left base of the skull, soft tissue, both maxillary sinuses and the sphenoid sinus; isolation of S. vasiformis from the tissue; and demonstration of mucoraceous antibodies by enzyme-linked immunosorbent assay. Fluorescent antibody studies carried out with a Rhizopus arrhizus conjugate, stained hyphal fragments in tissue with a 2+ intensity.

A case of systemic zygomycosis caused by Apophysomyces elegans in a 56-year-old man is described. The left kidney and the bladder showed presence of broad, nonseptate-to-infrequently septate hyphae in both the bladder lesion and in the septic kidney. Surgical debridement and treatment with amphotericin B cured the infection. No underlying immune defect was ever demonstrated, and the patient was not hyperglycemic or acidotic at any time. This zygomycetous fungus closely resembles Absidia corymbifera, but is distinguished by its distinctive morphological features.

Phialemonium obovatum was found to be the cause of osteomyelitis in a German shepherd dog. Histologic examination of the biopsied material from the left tibia revealed septate, irregularly branched hyphae, swollen cells, and ovate-to-spherical cells divided by a transverse septum. The majority of the fungal elements were hyaline, but a few had lightly pigmented cell walls that had a greenish yellow tint. The presence of melanin in the cell walls of the hyphae and especially in their septa was verified by the use of the Fontana-Masson silver stain. P. obovatum formed moist, off-white-to-ochraceous, spreading colonies with a characteristic green pigment on their reverse side. The pigment was more prominent in cultures grown at 37 degrees C than in those grown at 25 degrees C. The isolate also grew at 40 degrees C. The dog isolate produced characteristic adelophialides without conspicuous collarettes and also basal septa from the creeping vegetative hyphae growing on the surface of the medium. The numerous obovate phialoconidia were smooth and one-celled.

Pythium insidiosum was isolated from the subcutaneous tissue of a 1-year-old tan crossbreed dog and from the intestinal tract of an 18-month-old Samoyed male. Gomori's methenamine silver stain was superior to hematoxylin and eosin in demonstrating the organism in tissue sections. The agent was identified as P. insidiosum by zoospore formation in an aqueous yeast extract solution containing grass blades. Exoantigens produced in culture were shown to be identical to known P. insidiosum antigens by microimmunodiffusion.

We studied two cases of phaeohyphomycosis that occurred in Japan. Histopathologic examination of biopsy material showed the presence of dematiaceous catenulate fungal cells and mycelium characteristic of phaeohyphomycosis. In detailed mycologic study of the two cultures isolated from the patients we found that both formed conidiogenous cells with proximal swellings with long, neck-like extensions bearing distinct annellations and clusters of conidia at their apices. The isolates were identified as Exophiala moniliae de Hoog. These two Japanese cases are the second and third known cases of phaeohyphomycosis caused by E. moniliae and the first recorded in that country.

Phialophora verrucosa and P. americana, two dematiaceous hyphomycetes, are known to cause chromoblastomycosis. Even though most medical mycologists consider P. americana as synonymous with P. verrucosa, others maintain them as two distinct species on the basis that the phialides of P. americana have deeper collarettes than those of P. verrucosa. Thirty-two isolates, identified either as P. americana or P. verrucosa, were studied for their morphologic, physiologic, and antigenic characteristics to evaluate their taxonomic status. Collarette morphology was found to be a variable character in 12 of the 32 isolates. Those 12 produced phialides with both shallow and deep collarettes. All of the isolates hydrolysed urea within 7 days at 25 degrees C, and failed to liquefy gelatin after 3 weeks at 25 degrees C. None of the isolates decomposed casein, xanthine, or hypoxanthine at the end of 3 weeks at 25 degrees C. All decomposed tyrosine. They grew at 25 degrees C and 37 degrees C, but failed to grow at 40 degrees C. The antigenic relationship between the two species was studied by the exoantigen procedure. The 32 isolates showed close antigenic relatedness. Adsorptions of antisera with homologous and heterologous antigens rendered the antisera free of precipitin bands when studied by the microimmunodiffusion test. The depth of phialide collarettes produced by the two species, being found to be variable character, and the identical nature of the two species with respect to their physiologic and antigenic characteristics, led us to conclude that P. americana should be considered as a synonym of P. verrucosa.

We report disseminated, fatal fungal disease involving subcutaneous and visceral tissues in 4 captive snakes (1 Elaphe guttata, 2 Crotalus horridus, and 1 Pituophis melanoleucus). The etiologic agent, which was abundant in the lesion, had a rounded form in vivo with a prominent nucleus. These cells averaged 17 microns in diameter and reproduced by fission, forming clusters of two or four daughter cells. The etiologic agent was isolated on Sabouraud dextrose agar from one of the snakes. It also grew well on various mycologic media, forming soft, raised, glabrous, tannish colonies. The colonies were composed of large spherical cells with prominent nuclei that reproduced by fission like those seen in tissue. In addition, some of the cells were observed to germinate, forming rudimentary hyphal filaments that were up to 8 microns in diameter and 100 microns in length, with occasional septa and thick-walled structures regarded as azygospores. We consider the fungus to be a zygomycete that may belong to the order Entomophthorales.

Scolecobasidium humicola was isolated from granulomatous lesions on the tail and foot of a cat. The paw lesion, of 2 years duration, had recurred after surgical debridement and antibiotic therapy. In tissue sections of the biopsy, S. humicola was observed in the form of broad, septate, dematiaceous hyphal elements and thick-walled, chlamydoconidium-like cells. The cat was successfully treated with ketoconazole and has since shown no signs of recurrence. This is the first record of S. humicola being an etiologic agent of phaeohyphomycosis in a mammalian host.

Three cases of mycetoma were studied in the San Francisco Bay area of northern California during the period from 1960 to 1973. In each case the causal agent was identified on the basis of the histological structure of the granules and by isolation of the etiological agent in pure culture. The fungus in all cases was found to be Acremonium falciforme. This is the first report of A. falciforme occurring as a disease agent in the United States.

Following an injury to the right eye, a corneal ulcer with hypopyon developed in a leprosy patient. Direct examination of the corneal scrapings on three occasions showed septate, branched, dematiaceous hyphal elements. When scrapings were cultured on Sabouraud's glucose and brain heart infusion agars. Bipolaris hawaiiensis was isolated repeatedly. The patient responded successfully to treatment with nystatin ointment, although the central opacity of the cornea remained and visual acuity did not improve.