An outbreak of aspergillosis in children with acute leukemia

Abstract

SINC~ 1970, a number of reports of invasive Aspergillus infection in immunosuppressed patients have appeared in the literature. 16 Though a potential complication of any immunosuppressed state, aspergillosis occurs primarily in patients with leukemia.~ Inhalation of spores is believed to be the usual route of transmission in human infections, although the gastrointestinal tract, skin, and nasopharynx have been observed as infrequent primary portals of entry?' 7 Nosocomial hazards for Aspergillus are difficult to assess, since this is an ubiquitous organism. The simultaneous discovery of contaminated ventilation systems and cases of aspergillosis within a hospital have been reported5 -6 However, no cluster of cases has been described previously. During a two-month interval, five children with acute lymphoblastic leukemia were admitted to Texas Children's Hospital and subsequently developed invasive Aspergillus infections. The features of these patients are summarized in the Table. The presence, in tissue specimens, of dichotomously branching, septate hyphae, 3 to 5 microns in diameter, stained with methamine silver nitrate, established the diagnosis of aspergillosis in all patients. Only one patient had positive antemortem cultures.