Invasive aspergillosis of paranasal tissues in children with malignancies.

Paranasal aspergillosis was encountered in five children with relapsed malignancies. All had received broad-spectrum antibiotics within two weeks of development of aspergillosis, and all had absolute granulocyte counts less than 200/mm3 for at least three weeks. None had received prior antifungal therapy. There was an average delay of eight days before the correct diagnosis was established by either biopsy or culture. These data emphasize the need to obtain surveillance cultures of the upper respiratory tract passages in severely neutropenic patients receiving prolonged antibiotic therapy, and raise a question concerning prophylactic use of antifungal therapy in this group.