INVASIVE ASPERGILLOSIS PRECEDED BY LEGIONELLA-PNEUMONIA - REPORT OF 2CASES AND LITERATURE-REVIEW

We present 2 autopsy-proven cases of fatal disseminated aspergillosis preceded by pulmonary Legionella infection. Over the 15 yr period from 1978-1993, there were only 8 autopsy cases of disseminated aspergillo sis in our institution. Legionella infection is also relatively uncomm on in our institution, with only 5 serologically documented infections in the past 3 yr. Two other studies in the literature also reported s uch dual infection in small case series. Thus, the fact that 25% of ou r patients dying of disseminated aspergillosis had preceding Legionell a infection may not have been a chance event. The possibility of super infection by Aspergillus should be considered in patients with unexpla ined deterioration during appropriate treatment for Legionella.