ANALYSIS OF THE RECENT - CLUSTER OF INVASIVE FUNGAL SINUSITIS AT THE TORONTO-HOSPITAL-FOR-SICK-CHILDREN

Objective: The aim of this study was to review the eight histopatholog ically proven cases of invasive fungal sinusitis that occurred at the Toronto Hospital for Sick Children between 1985 and 1995, seven of whi ch that clustered between March 1990 and February 1992. Design: A retr ospective review of the relevant cases and a review of the literature are presented. Method: A clinical review of this rare, life-threatenin g entity, occurring almost exclusively in severely neutropenic patient s is presented and compared to the relevant clinical findings from an analysis of this series, the largest reported to date and first to doc ument a significant clustering (p < .01). Conclusion: We conclude, bas ed on epidemiologic evidence, that this clustering was directly relate d to the release of airborne fungal spores from dormant soil reservoir s disturbed during hospital construction. Therefore, we strongly advoc ate increased vigilance with respect to precautions against airborne p athogens wherever severely neutropenic hosts are treated.