An outbreak of pneumocystis pneumonia in children with acute lymphocytic leukemia
T. K. Ruebush 2nd, R. A. Weinstein, R. L. Baehner, D. Wolff, M. Bartlett, F. Gonzles-Crussi, A. J. Sulzer and M. G. Schultz
Between Jan 1 and Oct 31, 1975, a cluster of ten cases of pneumocystis
pneumonia occurred in children with acute lymphocytic leukemia (ALL) at the
James Whitcomb Riley Hospital for Children in Indianapolis. The risk of
infection appeared to be related to the intensity of chemotherapy.
Furthermore, illness developed in nine of the ten patients between 30 and
100 days after initiation of therapy, suggesting a period of heightened
susceptibility to infection. An indirect immunofluorescent test was used to
detect antipneumocystis antibodies in serum samples collected from patients
with pneumocystis pneumonia and their contacts. Members of the Riley
Hospital staff who had close contact with infected children had a higher
prevalence of elevated antibody titers (7/12) than other staff members
(2/22; P = .004) or parents of infected patients (0/8; P = .01). This
suggests that transmission of pneumocystis may occur within the hospital
environment.
