Punch biopsy specimens from 4 patients with confirmed diagnosis of tinea versicolor were investigated. Hypopigmented, hyperigmented and uninvolved sites from the same subject were compared in relation to ultrastructural alterations as a result of infection with Malassezia furfur, by light, scanning, and transmission electron microscopy. Hyperpigmented skin had thicker stratum corneum than hypopigmented but both were thicker than the uninvolved skin. A large number of tonofilaments were noticed in hyperpigmented sites in stratum granulosum. In hypopigmented skin the melanosomes were individually dispersed and fewer in number than the uninvolved skin. In hyperpigmented skin, the melanosomes were sequestered in most cells suggesting difficulty in the transfer of melanosome granules to keratinocytes. In both cases of pigmentation the most readily affected parts of the cells were cyto-plasmic organelles with a latent effect on the nucleus and nucleolus. We postulate that either stage of pigmentation (hyperpigmentation or hypopigmentation) is an intermediary in nature as a result of M. furfur invasion.

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The antistreptococcal immune responses in 130 children with Acute Rheumatic Fever (ARF), seen in Kuwait, over a period of three years, are presented. The ages of children ranged between three to 13 years. One hundred and three presented in initial attacks while 27 presented in recurrences. The geometric mean of antistreptolysin 'O' (ASO) and antihyalurodinase (AH) titres for all patients were 488 Todd Units and 595 units, respectively. In children under the age of eight years, but not above this age, the geometric mean of ASO titres was significantly higher in children with carditis than in those without carditis (P less than 0.01); there was no significant difference in AH titres between the two groups. Analysis of the Geometric Mean Titres (GMT) of both antibodies in relation to other variables is also presented.

Summary: Tinea versicolor in Kuwait was found to be more predominant among males (60.9%) than females (39.1%). Patients of the age group 20–29 years had higher frequency of infection (48.2%). These patients had had the longest durations of infection and the most frequent rate of occurrence: Their infection tended to be chronic and recurrent. The most common sites of tinea versicolor infection were the chest and neck in both male and female patients. Anatomical distribution of infection was remarkably different in males than females. Although lesions of tinea versicolor were typically observed in locations such as the shoulders, arms and abdomen, eruptions in the interdigital spaces, axillae, face and groin were also seen. The observation of tinea versicolor lesions in the interdigital spaces adds another atypical site of infection with M. furfur. Hyperpigmented lesions were more predominantly observed than hypopigmented type of lesions. This predominance of hyperpigmentation might be due to the presence of M. furfur which was found in abundance in the hyperpigmented lesions. Genetic transfer of susceptibility to tinea versicolor infection was not substantiated in our investigation, although we found that 17.7% of our patients had positive family history. Occurrence of tinea versicolor was more common in the summer and spring months (89.7%) and gradually dissipated during the autumn and winter months. This predominance of tinea versicolor might be related to the hot climate in Kuwait during the months of April to September. Our findings suggest that sweating may have no role in determining the intensity of tinea versicolor infection or the extent of lesions, rather it seems likely that it could be an important factor in producing the unpleasent symptoms of tinea versicolor once infection has been established. Zusammenfassung: In Kuwait kommt die Pityriasis versicolor unter Männern (60,9%) häufiger vor als bei Frauen (39,1%). Besonders betroffen war die Altersgruppe zwischen 20 und 29 Jahren mit einem Anteil von 48,2%. Diese Patienten hatten auch die längste Dauer der Infektion und zeigten die größte Rückfallrate: Bei ihnen tendierte die Mykose zu besonders chronischem und häufig rezidivierendem Verlauf. Die Pityriasis versicolor war am häufigsten an der Brust und am Hals bei männlichen und weiblichen Patienten lokalisiert. Bei Männern wies im übrigen die anatomische Verteilung der Erkrankung deutliche Unterschiede zu der Verteilung bei Frauen auf. Obwohl die Veränderungen der Pityriasis versicolor in typischer Lokalisation wie Schultern, Armen, Abdomen beobachtet wurden, fanden sich auch Herde in den Interdigitalräumen, in den Achselhöhlen, im Gesicht und in den Leistenbeugen. Die Beobachtung von Pityriasis versicolor‐Herden in den Fingerzwischenräumen stellt eine neue atypische Lokalisation dar. Hyperpigmentierte Herde wurden häufiger beobachtet als hypopigmentierte. Das Überwiegen der Hyperpigmentierung ist möglicherweise auf die Gegenwart von Malassezia furfur zurückzuführen, da der Erreger in den hyperpigmen...

Summary Pulmonary cryptococcosis was not established until day 7 post respiratory exposure of mice to Cryptococcus neoformans. This observation indicates that the organism might have initially colonized foci in the upper respiratory tract (mucous membranes or lymphoid tissues) prior to the establishment of pulmonary cryptococcal infection. Pulmonary cryptococcosis served as the primary source of the yeast for subsequent dissemination to the liver, spleen, and finally to the brain. At day 56, Cr. neoformans was isolated from lungs (100%) and brains (33%) of infected animals sacrificed at this period. Spleens and livers of the same animals were culturally negative to the organism. Perhaps there is another line of dissemination to the central nervous system besides hematogenous spread. Subclinical respiratory infection with 1.6 × 104 Cr. neoformans conferred immunity on mice against a lethal intravenous challenge with 1.7 × 106 viable Cr. neoformans. This acquired immunity was detected at day 7, peaked at days 21 and 28, then started to subside on day 42 post infection. At this time an increased rate of mortality occurred and continued to increase until day 56 when it remained on the same level until day 84 post exposure. Zusammenfassung Eine pulmonale Cry tokokkose war bei Mäusen, die auf aerogenem Wege mit Cryptococcus neoformans infizert wurden, nicht vor dem 7. Tag nachweisbar. Dies ließ vermuten, daß der Ptilz zuerst Herde in dem oberen Respirationstrakt—Schleimhäute oder lymphoides Gewebe—bildete, und erst danach kam es zur eigentlichen Cryptokokkose der Lunge, Die Aussaat der Hefe in die Leber, in die Mlilz und letztlich in das Gehirn erfolgte von der Lungenmykose, die als primäre Infektionsquelle angesehen wird. Bei infizierten Tieren, die am 56. Ta getötet wurden, konnte Cr. neoformans in 100 % der Fälle aus der Lunge und in 33 % der Fälle aus dem Gehirn isoliert werden. Bei den gleichen Tieren ließ sich der Pilz nicht aus der Milz und der Leber kulturell nachweisen. Möglicherweise besteht außer der hämatogenen Streuung ein weiterer Weg für die Verbreitung des Sproßpilzes. Eine subklinische aerogene Infektion mit 1,6 × 104 Cr. neoformans‐Zellen führte bei Mäusen zur Immunität gegen eine letale Dosis von 1,7 × 106 lebender Cr. neoformans‐Zellen. Diese erlangte Immunität wurde am 7. Tag festgestellt. Am 21. und 28. Tag erreichte diese einen Gipfel, und nach dem 42. Tag nach der Infektion begann sie abzunehmen. Die Mortalitätsrate stieg zu dieser Zelt an und nahm bis zum 56. Tag zu. Danach blieb die Mortalitätsrate bis zum 84. Tag unverändert.