pulmonary hemorrhage/hemosiderosis among infants - Cleveland
Infeld MD, Smith P, Judge C, Horgan TE, Allan T, Zimomra JA, Mortensen
BK, Burkett SA, Winpisinger-Slay K, Wagner S. January 1993 -
November 1994. Morbidity and Mortality Weekly Report. December, 1994;
Purpose: This CDC report marks the first publication of the
investigation of a cluster of pediatric pulmonary hemosiderosis cases.
Design: Case Series (Public Health Service Announcement).
Outcome: This was the first report from the CDC pertaining to a
potential association between exposure to Stachybotrys and pulmonary
hemorrhaging in eight black infants from a single hospital in Cleveland,
Ohio between January 1993 and November 1994. Dearborn and colleagues
described the laboratory signs and clinical symptoms observed in these
children. The report stated that the blood testing showed results
consistent with pulmonary hemorrhage. These indications persisted more
than two weeks after the initial treatment of the disease. Five infants
required mechanical ventilation for respiratory assistance, and there
was one death, resulting from recurring hemorrhaging. Elevated antibody
(IgG) levels to cow's milk were detected in over 70% of the infants
Significant Quotes: "Cultures of blood, urine, and bronchoalveolar
lavage from seven infants were negative for bacterial, mycotic, and
viral pathogens." (p. 882).
"Massive acute pulmonary hemorrhage occurs rarely in infants; it usually
is attributed to cardiac or vascular malformations, infectious
processes, immune vasculitides, trauma, or known milk protein
allergies." (p. 882).
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