Disseminated aspergillosis was not reported before the advent of antibiotics. In a review of the world literature Tan et al1 found 22 cases occurring since 1939, and described a further one. Almost all these cases, and others reported subsequently2,3 had received antibiotics or steroids, or both, and most had an underlying debilitating illness; one patient had Cushing's syndrome.4
The present case is unusual in that the portal of entry seems to have been a peritoneal infection resulting from peritoneal dialysis.
A primigravida, age 22, had a normal antenatal course, until Nov 8, 1965 (36th week), when her blood pressure (BP) was 130/80 mm Hg and the urine contained a trace of protein. The major clinical events, together with antibiotic, steroid, and dialysis treatment are summarized in Fig 1. On Nov 20 (38th week) at 4:30 pm nausea, vomiting, and intermittent epigastric pain developed. The pain