Investigations into the role of fungi in pulmonary diseases

Summary 32 cases of non tuberculous chronic pulmonary diseases and 10 cases of chronic pulmonary tuberculosis not responding to the routine treatment, were investigated to find out if fungi played any role in their etiology. Fungi were isolated from 9 cases of non-tuberculous and 2 cases of tuberculous pulmonary infections.Fungi as such seem to play some role in the etiology of Pulmonary Diseases and probably also help in keeping up the disease in tuberculous cases. Mycostatin is the drug of choice in the treatment of pulmonary moniliasis.Sputa and bronchial aspirates from 32 cases of non-tuberculous chronic pulmonary diseases and 10 cases of chronic pulmonary tuberculosis, not responding to the routine treatment, were repeatedly examined to find out if fungi played any role in their etiology. Fungi were isolated from 9 cases of non-tuberculous (C. albicans from 8 andActinomyces bovis from 1) and two cases (C. albicans from both) of tuberculous pulmonary infections. All the strains ofC. albicansandA. bovis isolated were tested for their sensitivity against Nystatin. Only strains ofC. albicans were found to be sensitive to Nystatin. Two cases treated with Mycostatin improved rapidly.

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Zusammenfassung Sputum and Bronchialsekret von 32 Fällen von nicht-tuberkulösen chronischen Lungenkrankheiten und von 10 Fällen von chronischer Lungentuberkulose, die auf Routinebehandlung nicht ansprachen, sind wiederholt daraufhin untersucht worden, ob Pilze eine aetiologische Rolle spielten. Pilze sind in 9 nicht-tuberkulösen Fällen (C. albicans in 8,Actinomyces bovis in einem Falle) und in 2 tuberkulösen Fällen (C. albicans in beiden) isoliert worden.Alle isolierten Stämme vonC. albicans andA. bovis sind auf ihre Sensitivität gegen Nystatin untersucht worden. NurC. albicans war sensitiv gegen Nystatin. Zwei Fälle, die mit Mycostatin behandelt wurden, zeigten rasche Besserung.

     

A survey of the pathogenic fungi of mycotic infection of the scalp in U.A.R.

Summary 121 cases diagnosed clinically as tinea capitis were examined microscopically and culturally. In 80 cases the causative organism could be cultured.T. violaceum was the causative organism of the majority of the cases as it caused 47.5 % of the cases,T. schoenleinii 31.3 %,M. canis caused 26.1 %,T. tonsurans 1.3 %, whileM. audouinii caused none. In most of the cases ofT. violaceum infection, scaling and mild inflammation were the common clinical manifestation. The black dot or the bald patch appearance was rarely seen. Favus did not necessarily show the characteristic scutulae; in many cases ofT. schoenleinii infection, only few scales and mild inflammation were present.     

A Case of Rhinoorbital Mucormycosis in a Leukemic Patient with a Literature Review from Turkey

Mucormycosis (Zygomycosis) is a rare, invasive, opportunistic fungal infection of the paranasal sinuses, caused by a fungus of the order Mucorales. We report a case of rhinoorbital mucormycosis caused by Rhizopus oryzae in an acute lymphoblastic leukemia patient and review the 79 Mucormycosis cases reported in the last decade from Turkey. In our case, the diagnosis was made with endoscopic appearance, computerized tomography of the paranasal sinuses, and culture of the surgical materials. Following aggressive surgical debridement and parenteral amphotericin B therapy, the patient recovered completely. In Turkish literature, rhinocerebral manifestations were the most common form of the mucormycosis (64 cases), followed by pulmonary form (6 cases). The most common risk factor was hematologic malignancies (32 cases) and diabetes mellitus (32 cases), similar to those reported from the rest of the world. The etiologic agents responsible for the review cases were Rhizopus sp., Mucor spp., Rhizomucor spp., Rhizopus oryzae, Mucor circinelloides, and Lichtheimia corymbifera. Although various treatment modalities were used, amphotericin B was the mainstay of therapy. Mortality rate was found to be 49.4% in review cases. It seems that strong clinical suspicion and early diagnosis, along with aggressive antifungal therapy and endoscopic sinus surgery, have great importance for better prognosis in mucormycosis.     

The role of Helicobacter pylori in patients with hypothyroidism in whom could not be achieved normal thyrotropin levels despite treatment with high doses of thyroxine

Background: Helicobacter pylori infection is a most frequent cause of chronic gastritis. H. pylori may decrease absorption of oral thyroxine by decreasing gastric acid secretion in the stomach. In this study, we aimed to investigate the change in thyroid function tests of the cases after H. pylori eradication who were not responding to high doses of thyroxine treatment before H. pylori eradication. Methods: Hypothyroid cases who were not responding to high doses of thyroxine among the ones presented to Endocrinology and Gastroenterohepatology Clinics of Sisli Etfal Training and Research Hospital between 2009 and 2010 were included in the study. Thyroid function tests were performed two times in all cases before and after H. pylori eradication. Duodenal, antral and corporal biopsies, and jejunal aspirates and biopsies were taken during upper gastrointestinal system endoscopies performed in all patients. Cases without intestinal pathology were included in the study. Results: Serum thyrotropin (TSH), free T3, and free T4 values before H. pylori eradication were 30.5 ± 28.8 IU/mL, 2.64 ± 0.56 pg/mL, and 0.92 ± 0.32 ng/mL, respectively, and after eradication were found to be 4.2 ± 10.6 IU/mL, 3.02 ± 0.61 pg/mL, and 1.3 ± 0.34 ng/mL, respectively (p values <.001, .002, and <.001, respectively). After H. pylori eradication treatment, TSH decreased in all of the cases, factitious thyrotoxicosis developed in % 21 of these cases. Conclusion: In hypothyroid cases, H. pylori gastritis may be responsible for an inadequate response to the treatment. H. pylori eradication in the cases receiving high doses of thyroxine has a risk for thyrotoxicosis.     

Dermatophytosis among the students of the elementary schools in Taipei city

Summary A survey of dermatophytosis among the students of all elementary schools in Taipei City was performed from April to June, 1957. A total of 2687 students, 1419 boys and 1268 girls, were examined as a random sample.There were 85 cases of dermatophytosis (3.16%) including 80 cases of tinea capitis (2.98 %), two cases of tinea glabrosa (0.07 %), one case of tinea pedis (0.04 %) and two cases of favus (0.07 %). Seventy eight out of 80 cases of tinea capitis were male.Mycological study of 80 cases from these patients was performed and 49 strains of the causative organisms were obtained. Among 46 strains cultured from tinea capitis, there were 39 cases (84.8 %) ofT. ferrugineum, which is the commonest species in Formosa, 6 cases (13.0 %) ofT. violaceum and one case ofT. rubrum.Favus is an endemic dermatophytosis in middle and southern China but is rare in Taipei City.The relationship between the causative dermatophytes and the clinical findings of tinea capitis were described. Clinical symptom due toT. ferrugineum was different from that due to other organisms.     

Interactions between a stream caddisfly and the algae on its case: factors affecting algal quantity

1. Field experiments were conducted to examine interactions between larvae of the caddisfly Gumaga nigricula and the algae (primarily diatoms) located on their sand grain cases. Floating experimental enclosures were placed in sunlit pools of a California stream. Treatments applied to occupied cases, or to those from which caddisflies had been removed, included variations in grazer density, addition of nutrients, and modification of illumination using shade cloth. 2. Neither faecal-enriched agar in empty cases nor injections of faecal material into plugged cases affected case chlorophyll a concentration; injected nutrients (N and P), however, did increase chlorophyll a concentration. Faecal material may be nutrient poor, or nutrients may not be readily released. In addition, the relatively impermeable case wall may reduce the likelihood that nutrients from caddisflies reach the algae on the outer case surface. 3. Although a Gumaga larva may graze algae from its own case, grazing by conspecifics and the caddisfly Helicopsyche borealis causes a greater reduction in the chlorophyll a content of cases. 4. Chlorophyll a content of empty cases was decreased by experimental reduction of light. Because of shading associated with burrowing, chlorophyll a content of cases occupied by Gumaga was low and was unaffected by experimental light reduction. 5. Removal of Gumaga from its case results in rapid accrual of algae. Thus, the net effect of larval presence is to diminish the algal content of its case.     

Phenotypic variability and therapeutic implications of Candida species in patients with oral lichen planus

We investigated the prevalence and phenotypic variation of Candida species in oral lichen planus (OLP) and the therapeutic implications of our findings. Eighty patients with clinically and histopathologically confirmed cases of OLP (64 non-erosive, 16 erosive) and a control group of 80 healthy individuals with no predisposing factors for oral candidiasis were examined for evidence of Candida infection. Oral swabs and smears were obtained for cytology and culture. Identification, speciation and antifungal susceptibility tests of Candida isolates were performed using an automated microbial identification system. Fifty percent of erosive OLP cases, 28% of non-erosive cases and none of the controls showed evidence of Candida. Candida albicans was found predominantly in non-erosive OLP, while other Candida species were predominate in erosive OLP. Non-Candida albicans isolates (C. glabrata, C. krusei) were resistant to the commonly used antifungals, clotrimazole and fluconazole. Candida infection is common in cases of OLP. We recommend antifungal sensitivity testing prior to antifungal therapy for the erosive form of OLP.     

Miconazole in the treatment of superficial mycoses

Miconazole nitrate (2%) cream was evaluated in the treatment of superficial mycoses. Out of 116 patients having multiple clinical diagnoses, 66 cases were found to be positive by culture. Species of Trichophyton were the predominant etiological agents (in over 60%) followed by Candida species (20%) and Epidermophyton floccosum (15%). All the cases selected for study were followed up to a period of 4–18 months. A cure rate of 94.6 per cent was observed in all the cases where causal organisms were isolated. Significantly high cure rate (66%) was also seen in cases where causal organisms could not be isolated, including cases of tinea versicolor. Results of mycological examination were in confirmity with the clinical results. Read at the Symposium on Human Mycoses and Miconazole held in New Delhi, India, February, 1975.     

Analysis of insects colonised on human corpses during autopsy in Riyadh,Saudi Arabia

In medicolegal cases, an analysis of the presence of insects on human bodies may have potential legal significance. This study investigates the presence of insects on human bodies during autopsies in legal medicine. It was implemented in Riyadh, Saudi Arabia. Nine cadavers were examined, respectively, from four cases of homicide, two cases of burning, one suicide, one accident and one case of neglect. Insects associated with the human corpses were carefully collected and identified using valid taxonomic keys. Three of the cadavers were of children with ages ranging from seven months to nine years. In seven cases decomposition had occurred outdoors while in two cases it was indoors. Overall, eleven different species of insects were identified. Six of the cases exhibited species from five families within Diptera (Calliphoridae, Muscidae, Ulidiidae, Tachinidae and Sarcophagidae), specifically Chrysomya albiceps (Wiedemann), Musca domestica (Linnaeus), Tachinidae sp. (Bigot), Physiphora alceae (Preyssler) and Sarcophaga dux (Thompson). Six of the cadavers hosted beetles, which were identified as Dermestes maculatus (DeGeer), D. frischii (Kugelann), Necrobia rufipes (Fabricius), Nitidula bipunctata (Linnaeus), Pimelia interjecta (Solier) and Latridiidae sp. (Erichson). Moreover, the suicide corpse was colonised by more fly species than the other corpses, while the beetles colonised the homicide and accident corpses more than the other corpses. Analysis of the diversity of insects on human corpses may lead to advances in the understanding of forensic entomology and more sophisticated estimates of the minimum post‐mortem interval.     

Evidence of anthropogenic trauma in marine mammals stranded along the central California coast, 2003–2015

A total of 11,162 stranded marine mammals was admitted to a rehabilitation center on the central California coast between January 2003 and September 2015. Six hundred seventeen animals (6%) had evidence of anthropogenic trauma (AT). California sea lions comprised the majority (83%) of AT cases, particularly by entanglement in marine debris (n = 277) and gunshot injuries (n = 165). Guadalupe fur seals had the highest prevalence of entanglement in marine debris. Cetaceans were primarily affected by boat collisions (n = 19). The highest numbers of overall strandings were recorded in 2009 (n = 1,690) and 2015 (n = 1,666); 2009 also had the highest total number (n = 137) and prevalence (8%) of AT cases. Prevalence of fishing tackle cases increased compared to similar data from 1986 to 1998 while prevalence of gunshot cases decreased, and other causes remained static. Cases of fisheries interactions were further examined and characterized, and when direct fisheries interactions were separated from other causes of AT, fisheries interactions accounted for 50% (n = 310) of all AT cases during the study period. Direct fisheries interactions were the most common type of AT observed among stranded marine mammals in central California. Tracking AT trends is important to further understand possible causes and inform mitigation efforts.     

Epidemiology of the dermatophytoses in the Florence area of Italy: 1985–1990

Between 1985 and 1990 we observed 2085 cases of dermatophytoses in the Florence area of Italy.Trichophyton rubrum andMicrosporum canis were the major etiological agents. 126 cases of dermatophytoses observed during this period were caused byTrichophyton mentagrophytes. Most of the patients came from rural areas or they kept pets.Epidermophyton floccosum ranked fourth in frequency (95 cases). The patients were adults and mainly males, most of whom engaged in sports or lived in group environments.Microsporum gypseum was isolated in 31 cases. Infections occurred directly from contact with soil or domestic animals. We report the principal clinical data concerning these last three dermatophyte infections.     

K-ras Gene Mutation Related to Histological Atypias in Human Colorectal Adenomas

To investigate the relationship of oncogene analysis to morphology, we analyzed K-ras gene mutations by dot-blot hybridization with and without consideration of histological atypias in individual colorectal adenomas. Each of 54 colon polyps were divided into two parts after fixation. One part was used as a mass to assess point mutations; the remaining portion of each polyp was paraffin-embedded, stained with hematoxylin and eosin, and examined for point mutations related to histological atypias. In the first part of our study, K-ras gene mutations at codon 12 were detected in 13 cases (24%). In the second part of our study, 12 cases had distinctly different histological atypias. From each of these 12 cases, two areas, one with higher or one with lower grade atypia in the same polyp were excised to analyze for K-ras gene mutation. Two of these 12 cases (17%) had the mutation in different areas of the same tumor. These two cases contained the mutation only in the areas with higher grade atypia, and only one case added information regarding ras mutation upon microdissection when compared to the entire biopsy. These results suggest that oligonucleotide hybridization can identify the majority of cases containing ras mutations despite regional morphologic variation. Individual cases, however, may contain clonal subpopulations within adenomas with different ras sequences from other regions within the same adenoma.     

Detection of promoter methylation of tumor suppressor genes in serum DNA of breast cancer cases and benign breast disease controls

Tumors are capable of shedding DNA into the blood stream. This shed DNA may be recovered from serum or plasma. The objective of this study was to evaluate whether pyrosequencing promoter DNA in a panel of 12 breast cancer-related genes (APC, BRCA1, CCND2, CDH1, ESR1, GSTP1, HIN1, P16, RARβ, RASSF1, SFRP1 and TWIST) to measure the degree of methylation would lead to a useful serum-based marker of breast cancer. Serum was obtained from women who were about to undergo a breast biopsy or mastectomy at three hospitals from 1977 to 1987 in Grand Rapids, MI USA. We compared the methylation status of 12 genes in serum DNA obtained from three groups of postmenopausal women (mean age at blood collection: 63.0 y; SD 9.9; range 35–91): breast cancer cases with lymph node-positive disease (n = 241); breast cancer cases with lymph node-negative disease (n = 63); and benign breast disease control subjects (n = 234). Overall, median levels of promoter methylation were low, typically below 5%, for all genes in all study groups. For all genes, median levels of methylation were higher (by 3.3 to 47.6%) in lymph node-positive breast cancer cases than in the controls. Comparing mean methylation level between lymph-node positive cases and controls, the most statistically significant findings, after adjustment of the false-positive rate (q-value), were for TWIST (p = 0.04), SFRP1 (p = 0.16), ESR1 (p = 0.17), P16 (p = 0.19) and APC (p = 0.19). For two of these four genes (TWIST, P16), the median methylation level was also highest in lymph-node positive cases, intermediate in lymph node-negative cases and lowest in the controls. The percent of study subjects with mean methylation scores ≥ 5% was higher among lymph node-positive cases than controls for ten genes, and significantly higher for HIN1 and TWIST (22.0 vs. 12.2%, p = 0.04 and 37.9 vs. 24.5%, p = 0.004, respectively). Despite relatively consistent variation in methylation patterns among groups, these modest differences did not provide sufficient ability to distinguish between cases and controls in a clinical setting.     

Studies on the fungal flora in the lung of human necropsy cases. A critical survey in connection with the pathogenesis of opportunistic fungus infections

An ecological study was carried out on the fungal flora in the human lung of 159 autopsy cases. Fungi were isolated from 129 cases (81.1%). Filamentous fungi consisting of 918 strains were isolated from 113 cases, and the dominant genera were Aspergillus and Penicillium. Yeasts were isolated from 58 cases, and the dominant genus appeared to be Candida.With morbid anatomical study, the incidence of the fungus isolation was examined from various points of view. It was concluded that even a healthy respiratory parenchyma of the human lung cannot be assumed as aseptic. However, only a few numbers of a few genera of air-born fungi were isolated.Special stress was laid on the exposure of the respiratory parenchyma of the human lung to air-born fungi in connection with the pathogenesis of opportunistic fungus infections.     

An approach to quantitative assessment of hemodynamic differences between unruptured and ruptured ophthalmic artery aneurysms

Background and purpose: Hemodynamic parameters are important in the pathogenesis, evolution and rupture of intracranial aneurysm. Energy loss (EL) has been applied for the rupture risk prediction of artery aneurysms recently. We proposed a new EL and further investigate its effects on the rupture of aneurysms. Materials and methods: Sixty-four patient-specific ophthalmic aneurysm datasets were divided into ruptured and unruptured groups based on their clinical history. Based on patient-specific 3D-DSA data, realistic models were retrospectively reconstructed and then analyzed by using computational fluid dynamic method. Results: The flow field feature EL in ruptured cases was significantly higher than that in unruptured cases. The average wall shear stress (WSS) and the maximum WSS in ruptured cases were higher than those in unruptured cases. Modified pressure loss coefficient (PLC_M) in ruptured cases was slight higher than that in unruptured cases but the difference has no statistical significance. Multivariate logistic regression analysis demonstrated flow field feature EL (p < 0.05) and the maximum WSS (p < 0.05) were the only independently significant variables to predict rupture of ophthalmic aneurysm. There were no differences in PLC_M, the maximum oscillatory shear index (OSI), the average OSI and AR between the two groups. Conclusion: Flow field feature EL may be a reliable factor to predict the rupture risk of aneurysms.     

Prevalence of dermatophytes and yeasts (Candida spp., Malassezia furfur) in HIV patients

The prevalence of dermatophytes and yeasts (Candida spp. and Pityrosporum spp.) was studied in 40 former drug-addicts, all of whom were HIV seropositive but otherwise had no other symptoms (2nd Stage CDC Atlanta, 1987). We considered 7 skin areas for dermatophytes and Pityrosporum spp. (scalp, forehead, nose, back, chest, groin, toe webs) and the mouth for yeasts. Dermatophytes were found in 8 (20%) and tinea pedis was the most common dermatophytosis: Tricophyton rubrum was the fungus most frequently isolated (6 cases or 15%). The HIV + group showed almost the same rate of dermatophytes colonisation compared to a group of 121 athletes and to the control group. Candida spp. was present in 27 cases (67.5%) but clinical oral lesions were evident only in 5 patients (12.5%). Statistically significant differences were found in the presence of Candida spp. in HIV patients and controls (p<0.05). The lipophilic yeast Pityrosporum ovale was evaluated with quantitative and qualitative methods. Quantitative variations were evident between HIV patients and controls. P. ovale was present in 10 cases: 3 (7.5%) of them showed dischromic lesions while in 7 cases (17.5%) no clinical symptoms were evident.     

KRAS and BRAF mutation analysis can be reliably performed on aspirated cytological specimens of metastatic colorectal carcinoma

N. K. B. Pang, M. E. Nga, S. Y. Chin, T.‐M. Ismail, G. L. Lim, R. Soong and M. Salto‐Tellez
KRAS and BRAF mutation analysis can be reliably performed on aspirated cytological specimens of metastatic colorectal carcinoma Background: Sanger sequencing is one of several reliable methods in use to detect KRAS and BRAF mutations to facilitate clinical patient selection for anti‐epidermal growth factor receptor (EGFR) monoclonal antibody therapy in unresectable metastatic colorectal adenocarcinoma (CRC). Most analyses are made on pretreatment biopsy or resection specimens. There is a scarcity of published studies on the suitability of cytological samples for KRAS testing in this setting. Methods: DNA extraction was attempted on 11 search‐retrieved paired cases of histological resections or excisions of CRC and their corresponding cytological samples (representing metastases) and tested for KRAS mutations in exon 2 and 3, as well as BRAF exon 15 mutations by Sanger sequencing. Only KRAS wild‐type cases were subjected to BRAF analysis because this is the setting with true diagnostic value, as these mutations are mutually exclusive. Results: Of the 11 paired cases analysed, only eight histology cases showed satisfactory DNA quality for sequencing. Thus, only eight of the corresponding cytology cases were analysed. Seven of the eight cases tested showed the same KRAS genotype on both the aspirated cytology specimen of metastatic carcinoma and the primary tumour (histological specimen), from which we derive an overall concordance rate of 87.5%. The single discordant case was likely to be a true difference as it was demonstrated again on repeat testing of both samples. No BRAF mutations were detected on the four KRAS wild‐type cases. Conclusion: A range of cytological samples are suitable for KRAS and BRAF mutation testing, be it from previously stained preparations or cell blocks. These samples would be highly valuable in cases where cytological samples are the only material available for mutation testing.     

Isolation of an antigen fromBlastomyces dermatitidis that is specific for the diagnosis of blastomycosis

The A antigen ofBlastomyces dermatitidis has been isolated and purified by DEAE column chromatography. In the complement-fixation test, the antigen reacted with 10 of 16 sera from patients with proven cases of blastomycosis and was negative with known positive sera from 7 cases of histoplasmosis, 5 cases of coccidioidomycosis, 5 cases of candidiasis, and 5 cases of cryptococcosis. In the enzyme-immunoassay test, 25 of 27 sera from cases of blastomycosis were positive, but all heterologous and normal sera tested were negative. The antigen gave a positive skin test with guinea pigs sensitized with killed yeast-phase cells ofB. dermatitidis and negative skin tests with guinea pigs sensitized with killed yeast-phase cells ofHistoplasma capsulatum.     

Role of opportunistic fungi in ocular infections in Nigeria

The importance of opportunistic fungal pathogens in causing ocular infections is emphasized. A study was conducted over a period of 4 years (1974–1977) to investigate the role of opportunistic fungi in causing mycotic keratitis and to elucidate certain aspects of epidemiology of this disease in Nigeria. Fifty-nine cases of corneal ulcers of suspected mycotic etiology were investigated. Fungal etiology was confirmed in 42 of these cases. The predominant etiological agent was Fusarium solani in 14 cases (33.33%) followed by Penicillium citrinum in 8 cases (19.04%) and Aspergillus fumigatus in 5 cases (11.90%). The yeasts were responsible for only 3 cases (7.14%) i.e. one each caused by Candida albicans, C. parapsilosis and C. guilliermondii. Among the remaining 12 cases, one was caused by F. moniliforme, 3 by A. flavus, 2 each by A. niger, Penicillium expansum and Penicillium sp., and one each by Cladosporium cladosporioides and Cladosporium sp. The clinical features of the cases are briefly described.The incidence of mycotic keratitis in relation to sex, age, occupation, trauma and other factors has been analysed. Corneal trauma appeared to be an important predisposing factor as 27 (67.28%) of the patients gave a history of injuries to the eye. Notably, a large number of patients were farmers and trauma was most often from palm tree leaf, thorn, kernel or other plant objects. Topical application of corticosteroids or broad spectrum antibiotics did not seem to play an important role in the etiology of keratomycosis. Cases were recorded throughout the year although the number of cases was higher in the months of March –May, and November–December than that during the rest of the year.The isolates of the causative agents were studied in detail for their morphological and cultural characters. The isolates of F. solani grew well at 37°C and survived at 40°C for more than 3 weeks. In vitro drug sensitivity tests indicated good antifungal activity of pimaricin and econazole for F. solani, clotrimazole and econazole for Aspergillus fumigatus, A. flavus and Penicillium citrinum, and 5-fluorocytosine for Candida spp.Investigations on the incidence of fungi in normal healthy eyes of 450 persons comprising 204 adults and 246 children yielded 204 isolates belonging to 21 genera of fungi. Cladosporium was most frequent (12.88%) followed by Penicillium (10.22%) and Aspergillus (6.66%). Another important fungus was Fusarium represented by 10 isolates, viz. 4 of F. solani, 2 of F. moniliforme, 1 of F. exysporum, and 3 of Fusarium sp. The yeasts were represented by two isolates each of Candida tropicalis, C. pseudotropicalis, C. krusei, Trichosporon sp and Cryptococcus albidus, and one of Candida guilliermondii. Successive culturing of fungi from normal eyes in a small group indicated that fungi occur in the outer eye generally as transients.The epidemiology of mycotic keratitis has been discussed in relation to the present findings and in comparison with observations of other investigators.