Adiaspiromycosis.

We have then a disease that, for many years (since 1942), was known only to infect lower animals; after a sporadic encapsulated adiaspore was observed by Doby-Dubois in 1964 in a patient's lung, a widely disseminated, clinically symptomatic case was reported from Czechoslovakia, rapidly followed by three mildly disseminated cases, one from Russia and two from Guatemala, with innumerable granulomas similar to the patient of Kodousek et al. patient. Alert observers contributed descriptions of single adiaspores in arrested granulomas of the lung. The finding of presumed adiaspores in the lumen of an appendix seems unique. The reaction to the adiaspores is a tubercular granuloma, with fibroblast, (few) epithelioid, and giant cells representing the main component of the tissue response. Most observers agree on the absence of necrosis--one reason why the lesions do not calcify. The natural history of the disease seems to be self-limited, even if the extent of the involvement of the lung parenchyma determines the gravity of symptoms. The sudden flurry of reports makes it likely that cases previously had been mistaken for C. immitis or infestation by parasites.