THERE is no accepted effective therapy for Cryptococcus meningitis. Patients are treated empirically, and the results are poor. The present paper is the report of a case in which the relatively new antibiotic, actidione,\s=r\ was used, with gratifying results. Experiments with other therapeutic agents and a second case of the disease treated unsuccessfully by the conventional methods are included. This infection is caused by a fungus popularly known as Torula histolytica and so named in 1916 by Stoddard and Cutler,1 who believed that cysts were caused in the host's tissues by the histolytic action of the fungus. Actually, the "cysts" were masses of the fungi with their capsules. Mycologists now properly call the organism Cryptococcus neoformans.2 The infection caused by this fungus is cryptococcosis.
REPORT OF CASESA white man aged 39, a paper-mill worker, began to lose weight, strength, and energy in October, 1948. Vitamins afforded temporary improvement. In May, 1949, specimens of stool revealed Hymenolepis nana, and he was given five "crystal-like" tablets (caprokot®?). This single treatment was unsuccessful ; so he was hospitalized the following month and given several liquid-containing capsules (Dryopteris felix-mas?). After he returned home, he complained of vertigo, frequent headaches, and nausea, which when associated with coughing resulted in vomiting. His wife then first noticed a change ; as she described it : "He seemed vacant men¬ tally, paid less attention to me and our three children except to become irritated by us, and cried easily without any reason." There were "two spells" in which "everything seemed to go dark" ; he sought his wife's aid, but "he could not speak and his eyes stared." Each time he was helped to bed at once, remained conscious, but did not recall the episodes after a few hours. His wife had further noted a gradual personality change and said, "I wondered what had come over him." On July 2, 1949, he was admitted to this hospital. He was vague about his illness and complained of vertigo, malaise, loss of weight, and generalized abdominal soreness and said he had been treated elsewhere for "tapeworms and a little malaria fever."
