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Pulmonary Oxalosis Caused by Aspergillus Niger Infection  

Cho, Gye Jung (Department of Internal Medicine, Research Institute of Medical Sciences, Chonnam National University Medical School)
Ju, Jin Young (Department of Internal Medicine, Research Institute of Medical Sciences, Chonnam National University Medical School)
Park, Kyung Hwa (Department of Internal Medicine, Research Institute of Medical Sciences, Chonnam National University Medical School)
Choi, Yoo-Duk (Department of Pathology, Research Institute of Medical Sciences, Chonnam National University Medical School)
Kim, Kyu Sik (Department of Internal Medicine, Research Institute of Medical Sciences, Chonnam National University Medical School)
Kim, Yu Il (Department of Internal Medicine, Research Institute of Medical Sciences, Chonnam National University Medical School)
Kim, Soo-Ok (Department of Internal Medicine, Research Institute of Medical Sciences, Chonnam National University Medical School)
Lim, Sung-Chul (Department of Internal Medicine, Research Institute of Medical Sciences, Chonnam National University Medical School)
Kim, Young-Chul (Department of Internal Medicine, Research Institute of Medical Sciences, Chonnam National University Medical School)
Park, Kyung-Ok (Department of Internal Medicine, Research Institute of Medical Sciences, Chonnam National University Medical School)
Nam, Jong-Hee (Department of Pathology, Research Institute of Medical Sciences, Chonnam National University Medical School)
Yoon, Woong (Department of Diagnostic Radiology, Research Institute of Medical Sciences, Chonnam National University Medical School)
Publication Information
Tuberculosis and Respiratory Diseases / v.55, no.5, 2003 , pp. 516-521 More about this Journal
Abstract
The Aspergillus species produces metabolic products that play a significant role in the destructive processes in the lung. We experienced a case of chronic necrotizing pulmonary aspergillosis caused by an Aspergillus niger infection, which contained numerous calcium oxalate crystals in the necrotic lung tissue. A 46-year-old man, who had a history of pulmonary tuberculosis, presented with high fever, intermittent hemoptysis and pulmonary infiltrations with a cavity indicated by the chest radiograph. Despite being treated with several antibiotics and anti-tuberculosis regimens, the high fever continued. The sputum cultures yielded A. niger repeatedly, and intravenous amphotericin B was then introduced. The pathological specimen obtained by a transbronchial lung biopsy revealed numerous calcium oxalate crystals in a background of acute inflammatory exudates with no identification of the organism. Intravenous amphotericin B was continued at a total dose of 1600 mg, and at that time he was afebrile, although the intermittent hemoptysis continued. On the $63^{rd}$ hospital day, a massive hemoptysis (about 800 mL) developed, which could not be controlled despite embolizing the left bronchial artery. He died of respiratory failure the next day. It is believed that the oxalic acid produced by A. niger was the main cause of the patient's pulmonary injury and the ensuing massive hemoptysis.
Keywords
Aspergillus niger; Pulmonary Oxalosis; Calcium Oxalate Crystals;
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