Acute pulmonary hemorrhage in infants associated with exposure to Stachybotrys atra and other fungi

• Published in: Archives of pediatrics & adolescent medicine Vol. 152; no. 8; p. 757
• Main Authors: Etzel, R A, Montaña, E, Sorenson, W G, Kullman, G J, Allan, T M, Dearborn, D G, Olson, D R, Jarvis, B B, Miller, J D
• Format: Journal Article
• Language: English
• Published: United States 01.08.1998
• Subjects: Acute Disease; Air Microbiology; Case-Control Studies; Colony Count, Microbial; Female; Hemorrhage - epidemiology; Hemorrhage - microbiology; Hemosiderosis - epidemiology; Hemosiderosis - microbiology; Housing; Humans; Incidence; Infant; Lung Diseases, Fungal - epidemiology; Male; Ohio - epidemiology; Stachybotrys - growth & development; Stachybotrys - isolation & purification; Ohio
• ISSN: 1072-4710
• DOI: 10.1001/archpedi.152.8.757

A geographic cluster of 10 cases of pulmonary hemorrhage and hemosiderosis in infants occurred in Cleveland, Ohio, between January 1993 and December 1994. This community-based case-control study tested the hypothesis that the 10 infants with pulmonary hemorrhage and hemosiderosis were more likely to live in homes where Stachybotrys atra was present than were 30 age- and ZIP code-matched control infants. We investigated the infants' home environments using bioaerosol sampling methods, with specific attention to S atra. Air and surface samples were collected from the room where the infant was reported to have spent the most time. Mean colony counts for all fungi averaged 29 227 colony-forming units (CFU)/m3 in homes of patients and 707 CFU/m3 in homes of controls. The mean concentration of S atra in the air was 43 CFU/m3 in homes of patients and 4 CFU/m3 in homes of controls. Viable S atra was detected in filter cassette samples of the air in the homes of 5 of 9 patients and 4 of 27 controls. The matched odds ratio for a change of 10 units in the mean concentration of S atra in the air was 9.83 (95% confidence interval, 1.08-3 X 10(6)). The mean concentration of S atra on surfaces was 20 X 10(6) CFU/g and 0.007 x 10(6) CFU/g in homes of patients and controls, respectively. Infants with pulmonary hemorrhage and hemosiderosis were more likely than controls to live in homes with toxigenic S atra and other fungi in the indoor air.