[Peritoneal form of adiaspiromycosis (author's transl)]

A female patient, aged 30 years was subjected in 1977 to an appendectomy because of a perforated gangrenous appendix associated with purulent peritonitis. Postoperatively she developed an intractable constipation persisting for more than one year. Because of suspected intestinal stenosis an exploratory laparotomy was performed which failed to disclose the presence of stenosis. Histological studies of excised peritoneal specimens were suggestive of tuberculous peritonitis. Since cultivation failed to provide evidence of mycobacteria and the clinical symptoms were not characteristic of a tuberculous involvement of the peritoneum it was decided to carry out a re-evaluation of the original histological slides. This revealed that the patient was infected with adiaspores of the fungus Emmonsia crescens which were disseminated over the entire peritoneum from the perforated appendix. The difficulties associated with the diagnosis which are due to the striking morphologic similarity between the minute nodules in adiasporosis and those in productive miliary tuberculosis, as well as because of the acid-fast adiaspore capsules, are stressed. Since Emmonsia crescens is spread in some regions of Czechoslovakia it may be expected that humans will come into contact with its spores either by inhalation or by alimentary ingestion.