Nosocomial aspergillosis: a retrospective review of airborne disease secondary to road construction and contaminated air conditioners

A retrospective review of autopsy records was performed to evaluate a clustering of patients shown to have invasive pulmonary aspergillosis during the period July 1, 1978 through October 31, 1980 at Milwaukee County Medical Center, Milwaukee, Wisconsin. During this period, ten patients, all of whom were immunosuppressed by either hematologic malignancy (two), advanced age (one), or iatrogenically to prevent rejection of renal allografts (seven) were found to have invasive pulmonary aspergillosis. Prospective and retrospective evaluations of the hospital environment correlated the clustering of cases to recent road construction, and recovery of Aspergillus fumigatus and A. flavus from window air conditioners used in the renal transplantation ward suggested that some of the patients had acquired the infection nosocomially. A review of autopsy records during a seven-year period following the initiation of the renal transplant program but antedating road construction of any major consequence revealed no invasive aspergillosis among any patient autopsied.