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Diagnostic Significance of Pulmonary Oxalosis: Affirmation of Aspergillus niger Infection

Waraich, Kanwaljit MD*; Duggal, Abhijit MD, MPH*; Kartan, Ritha MD, FCCP*; Tanase, Armand MD*; Moonda, Afreen H. MD†

Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e31819fe3ec
Case Reports
Abstract

We report a case of pulmonary oxalosis secondary to invasive Aspergillus niger infection in a 75-year-old patient with chronic obstructive pulmonary disease. Bronchoscopic image revealed predominantly necrotic cellular debris, scattered fungal hyphae, and numerous birefringent calcium oxalate crystals. Bronchoalveolar lavage results were subsequently positive for A. niger infection. Necrotizing pulmonary infection due to A. niger is uncommon. Many Aspergillus species produce oxalic acid as a result of in vivo fermentation. Calcium oxalate crystals are responsible for tissue destruction. The detection of calcium oxalate crystals is strongly suggestive of A. niger infection. This case illustrates that the presence of oxalate crystals in tissue specimens can help diagnose A. niger infection.

Author Information

From the Departments of *Internal Medicine and †Pathology, Western Reserve Care System-NEOUCOMP, Youngstown, OH.

Reprints: Kanwaljit Waraich, MD, Department of Internal Medicine, Western Reserve Care System-NEOUCOMP, 500 Gypsy Ln, Youngstown, OH. E-mail: kanwalwaraich@yahoo.co.in.

This work was performed at Northside Hospital, Western Reserve Care System-NEOUCOMP, Youngstown, OH.

The authors report no conflicts of interest.

© 2009 Lippincott Williams & Wilkins, Inc.