Systemic blastomycosis in children.

Ten pediatric patients with systemic blastomycosis in Arkansas are reviewed. No particular age predisposition in childhood is apparent and there has been no change in incidence over the previous 40 years. Six of the 10 cases were male and 8 were black. Organ systems most commonly involved were pulmonary, skeletal and skin. With current therapy, usually amphotericin B as a single agent, the case fatality rate is less than 10%. Early recognition and institution of appropriate antifungal treatment remain the most important factors for survival and prevention of chronic pulmonary disease.

2-hydroxystilbamidine isethionate: a new fluorochrome for use in general pathology. II. The selective demonstration of fungi.

Paraffin sections of kidney, lung and oesophagus containing Aspergillus sp., Cryptococcus neoformans and Candida sp. were taken from human post mortem material and from the marmoset Callithrix jacchus. Sections were stained for 1-5 min in buffered 2-hydroxystilbamidine isethionate containing sodium metabisulphite after pre-oxidation in 1 per cent aqueous periodic acid. Sections were dehydrated, cleared and mounted in Polymount. When excited with UV light hyphae and fungal bodies fluoresced white contrasting sharply with yellow nuclear fluorescence. With blue light nuclei and fungi fluoresced yellow. Staining with the fluorochrome was pH dependent and behaved as a Schiff type reagent indicative of its probable behaviour as a basic dye. The method was simple, rapid and provided permanent fluorescent preparations which over a number of years did not fade with routine storage.

2-hydroxystilbamidine isethionate: a new fluorochrome for use in general pathology. I. The selective staining of DNA, mucosubstances and elastic fibres.

2 mg of 2-Hydroxystilbamidine isethionate when dissolved in 50 ml 0.1 M citric acid produced nuclear fluorescence in paraffin sections. Pre-hydrolysis in 5N HCl at room temperature increased selectivity of nuclear fluorescence. The addition of 100-200 mg sodium metabisulphite to the fluorochrome solution and preoxidation in periodic acid produced selective fluorescence of mucosubstances. Pre-oxidation with potassium permanganate induced selective fluorescence of elastic fibres. Yellow nuclear fluorescence contrasted clearly with blue/white fluorescence of mucosubstances and elastic fibres when excited with UV light. Unwanted nuclear fluorescence was quenched with 5% iron alum solution. Mast cells selectively fluoresced in acid alcoholic solutions of the fluorochrome. The procedures described were simple and rapid and produced permanent fluorescent preparations. The metachromatic fluorescence of nuclei in contrast to that of mucosubstances and elastic fibres eliminated the need for counterstaining.