Aspergillus Niger Infection Associated with Systemic Oxalosis: An Autopsy Diagnosis Without Culture

Abstract

This case report presents a 60-year-old male with a past medical history that included diabetes mellitus type II, chronic alcoholism, Hepatitis C infection, and presumptive pneumonia who died following a cholecystectomy. At autopsy, in addition to sequelae of the alcohol use (e.g., cirrhosis, splenomegaly, and esophageal varices), two contiguous black discolorations in the right lung composed of friable material and identified as fungal hyphae were found. Associated with the fungal hyphae was oxalic acid deposition. Oxalate crystals were also identified in the kidney of the decedent. Although no fruiting bodies were identified and no cultures were performed, a diagnosis of Aspergillus niger was made based upon the grossly apparent pigment production, lack of pigment within the fungal hyphae, and the oxalic acid production. Systemic oxalosis can occur as a result of an Aspergillus niger infection, and, its presence in the kidney would explain the decedent's worsening renal function prior to death.