Exophiala Pneumonia Presenting with a Cough Productive of Black Sputum

Area of Science:

• Medical Mycology
• Pulmonology
• Infectious Diseases

Background:

• Exophiala species are dematiaceous fungi known to cause subcutaneous and disseminated infections.
• Isolated pulmonary disease due to Exophiala is exceptionally rare.
• Melanoptysis, the production of black sputum, is an uncommon clinical sign with a narrow differential diagnosis.

Purpose of the Study:

• To report the first known case of Exophiala pneumonia presenting with melanoptysis.
• To highlight the diagnostic challenge of isolated fungal pneumonia.
• To discuss the clinical significance of melanoptysis in pulmonary infections.

Main Methods:

• Case report of a patient with bronchiectasis.
• Clinical presentation analysis including symptoms and physical findings.
• Review of relevant literature on Exophiala infections and melanoptysis.

Main Results:

• The patient presented with worsening dyspnea and cough productive of black sputum.
• Diagnosis of isolated Exophiala pneumonia was established.
• This case represents the first documented instance of Exophiala pneumonia associated with melanoptysis.

Conclusions:

• Exophiala pneumonia can present as isolated lung disease, albeit rarely.
• Melanoptysis can be a presenting symptom of Exophiala pneumonia.
• This case expands the clinical spectrum of Exophiala infections and emphasizes the importance of considering fungal etiologies in pulmonary disease with unusual sputum characteristics.