Related Experiment Videos
Aspergillus niger pneumonia with fatal pulmonary oxalosis
Y. Nakagawa1, Kazuyoshi Shimazu, Momoko Ebihara
1Department of Internal Medicine, National Kumamoto South Hospital, 2338 Matsubase, Toyofuku, Shimomashiki, Kumamoto 869-0524, Japan.
Abstract:
Metabolic products of Aspergillus species may play a significant role in the pulmonary destructive process. We describe a patient who died of respiratory failure, in whom postmortem examination revealed aspergilloma and numerous calcium oxalate crystals around the aspergilloma, as well as extensive consolidation areas. An-87-year-old man with a history of pulmonary tuberculosis and asbestos exposure was admitted to our hospital with fever and hemosputum. Chest radiograph on admission showed several small cavities in the right upper lung fields, but did not indicate the presence of a fungus ball. The patient was treated with several antibiotics, but his symptoms, and findings for inflammatory indicators and findings on chest radiographs deteriorated, and he died of respiratory failure 45 days after admission. Postmortem examination of the thoracic cavities showed marked involvement with extensive adhesions, fibrosis, caseation, and necrotic tissue. Aspergillus niger formed a mass in the right upper cavity and a localized invasion surrounding the cavity wall, but no organisms were detected in the left consolidation area. Numerous calcium oxalate crystals were found in the cavity wall, as well as an extensive consolidation area. We consider that oxalic acid produced by Aspergillus was the main cause of the patient's respiratory failure.
Insights
Metabolic products from Aspergillus, a common fungus, can cause severe lung damage. In a fatal case, oxalic acid from Aspergillus niger contributed to respiratory failure and extensive lung tissue destruction.
Area of Science:
- Pulmonology
- Mycology
- Toxicology
Background:
- Aspergillus species are known to cause pulmonary infections.
- Metabolic byproducts of Aspergillus may contribute to lung tissue destruction.
- Pulmonary tuberculosis and asbestos exposure are risk factors for lung disease.
Purpose of the Study:
- To describe a fatal case of respiratory failure potentially caused by Aspergillus metabolic products.
- To investigate the role of calcium oxalate crystals in pulmonary pathology.
Main Methods:
- Case report of an 87-year-old male with a history of pulmonary tuberculosis and asbestos exposure.
- Clinical observation including chest radiography and antibiotic treatment.
- Postmortem examination of thoracic cavities revealing fungal mass and tissue pathology.
Main Results:
- The patient presented with fever and hemosputum, deteriorating despite antibiotic treatment, leading to respiratory failure and death.
- Postmortem examination identified an Aspergillus niger mass in a lung cavity with localized invasion.
- Numerous calcium oxalate crystals were found around the aspergilloma and in consolidated lung areas.
Conclusions:
- Aspergillus niger infection and its metabolic product, oxalic acid, are implicated as the primary cause of the patient's respiratory failure.
- Oxalic acid may play a significant role in the destructive pulmonary process associated with aspergilloma.
- The presence of calcium oxalate crystals highlights a potential mechanism of lung injury in invasive aspergillosis.