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Cytology for Early Diagnosis of Cryptococcal Tracheo‐bronchitis

Introduction Cryptococcosis is a world-wide, often fatal disease, frequently diagnosed. only after symptoms and signs are too far advanced for effective therapy. Sufficiently early diagnosis is therefore essential. This was achieved in two cases where sputum was examined cytologically and the response to treatment with Mycostatin orally, and autogenous vaccine, was dramatic. During the influenza epidemic in Israel in Dec. 1969, a laboratory worker aged 62 Case (a) developed symptoms of “flu” with pyrexia, sore throat and tracheitis. These symptoms subsided, but a severe irritating productive cough, and chronic nasal obstruction with purulent discharge developed. After eight months “Chronic-bronchitis, following influenza”, was diagnosed: and because of the persistent cough, cytological examinations of sputum were performed, and intracellular organisms suggesting some blastomycotic infection, were found. A colleague aged 32 Case (b), anxious to disprove the diagnosis, injected some mice intraperitoneally with the sputum from Case (a). One week later he also developed a cough and symptoms of “flu”, with nasal obstrution. Cytological examination of his sputum also demonstrated the presence of organisms resembling those found in Case (a). These proved to be Cryptococcsu neoformans.