Fatal acute pulmonary aspergillosis in two children of one family.

Abstract

Rapidly fatal pulmonary infection with Aspergillus fumigatus is described in a previously healthy girl of 4 years and her sister of 14 months from a farming family. Both children were severely dyspneic and showed diffuse pulmonary mottling radiologically. Bacteriological tests in life were negative. No response was observed to antibacterial therapy. Widespread granulomatous inflammation of the lungs was found at necropsy in both patients and A. fumigatus was identified in the lesions. An apparently identical strain of this fungus was recovered from cattle-cake kept where the children had played. Cases of primary invasive pulmonary aspergillosis previously reported are briefly reviewed. The difficulties of diagnosis and treatment of this rare infection are discussed.