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Invasive Aspergillus niger with fatal pulmonary oxalosis in chronic obstructive pulmonary disease
E A Kimmerling1, J A Fedrick, M F Tenholder
1Medical College of Georgia, Augusta.
Abstract:
The ubiquitous Aspergillus fungus has numerous manifestations when associated with lung disease (primary Aspergillus pneumonia, aspergilloma, allergic bronchopulmonary aspergillosis, and invasive Aspergillus). This fungus also can colonize preexisting lung disease in an indolent manner and then acutely assume a more invasive nature. Although the species Aspergillus niger is infrequently encountered, the endobronchial visualization of black necrotic debris or a fungus ball or the finding of black acidic sputum or pleural fluid suggests the presence of A niger and the destructive by-product of its fermentation, oxalic acid.
Insights
Aspergillus fungus causes various lung diseases. Black debris, fungus balls, or acidic sputum may indicate Aspergillus niger infection and its oxalic acid byproduct.
Area of Science:
- Mycology
- Pulmonology
- Infectious Diseases
Background:
- The ubiquitous Aspergillus fungus presents diverse clinical manifestations in lung disease, including primary pneumonia, aspergilloma, allergic bronchopulmonary aspergillosis, and invasive forms.
- Aspergillus can initially colonize existing lung conditions indolently before becoming acutely invasive.
Observation:
- Aspergillus niger, though less common, is suggested by specific visual and chemical findings.
- Endobronchial observation of black necrotic debris or a fungus ball is a key indicator.
- The presence of black, acidic sputum or pleural fluid further suggests Aspergillus niger.
Findings:
- Aspergillus niger produces oxalic acid as a destructive fermentation byproduct.
- These characteristic findings aid in diagnosing Aspergillus niger infections.
Implications:
- Early identification of Aspergillus niger is crucial for timely and effective treatment.
- Understanding the role of oxalic acid may lead to targeted therapeutic strategies.
- Recognizing these specific signs can improve patient outcomes in Aspergillus-related lung diseases.