ACUTE PULMONARY HEMORRHAGE IN INFANTS ASSOCIATED WITH EXPOSURE TO STACHYBOTRYS ATRA AND OTHER FUNGI

Background: A geographic cluster of 10 cases of pulmonary hemorrhage a nd hemosiderosis in infants occurred in Cleveland, Ohio, between Janua ry 1993 and December 1994. Study Design: This community-based case-con trol study tested the hypothesis that the 10 infants with pulmonary he morrhage and hemosiderosis were more likely to live in homes where Sta chybotrys atra was present than were 30 age- and ZIP code-matched cont rol infants. We investigated the infants' home environments using bio- aerosol sampling methods, with specific attention to S atra. Air and s urface samples were collected from the room where the infant was repor ted to have spent the most time. Results: Mean colony counts for all f ungi averaged 29 227 colony-forming units (CFU)/m(3) in homes of patie nts and 707 CFU/m(3) in homes of controls. The mean concentration of S atra in the air was 43 CFU/m(3) in homes of patients and 4 CFU/m(3) i n homes of controls. Viable S atr was detected in filter cassette samp les of the air in the homes of 5 of 9 patients and 4 of 27 controls. T he matched odds ratio for a change of 10 units in the mean concentrati on 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, respectiv ely. Conclusion: Infants with pulmonary hemorrhage and hemosiderosis w ere more likely than controls to live in homes with toxigenic S atra a nd other fungi in the indoor air.