{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:39:48Z","timestamp":1782797988997,"version":"3.54.5"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We report a patient with severe cavitary pulmonary tuberculosis and Aspergillus niger superinfection, whose only comorbidity was untreated diabetes mellitus. <\/jats:p><jats:p>A. niger pneumonia was proven by PCR, sequencing and culture of pleural and respiratory secretions. The patient was successfully treated with a four-drug antituberculous regimen, liposomal amphotericin B (up to 5\u200amg\/kg\/d) and pleuro-pneumonectomy. Histology of the resected lung revealed destroyed lung tissue with inflammatory cells and fungal conidia. There were large deposits of polarising material, which was found to be calcium oxalate. There was also nodular caseating necrosis bordered by epitheloid cells and connective tissue. Thus, all diagnostic criteria for invasive A. niger infection were met. <\/jats:p><jats:p>Several local risk factors, such as extensive lung damage and tissue acidification, may have favoured superinfection by A. niger. This case highlights the diagnostic value of calcium oxalate crystals in lung tissue and the need for combined antimicrobial and surgical treatment in extensive invasive aspergillosis caused by A. niger.<\/jats:p>","DOI":"10.1055\/a-2110-2452","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T22:49:46Z","timestamp":1694472586000},"page":"639-644","source":"Crossref","is-referenced-by-count":1,"title":["Aspergillus niger pneumonia as superinfection in a patient with pulmonary tuberculosis"],"prefix":"10.1055","volume":"77","author":[{"given":"Santiago","family":"Ewig","sequence":"additional","affiliation":[{"name":"Thoraxzentrum Ruhrgebiet, Kliniken f\u00fcr Pneumologie und Infektiologie, EVK Herne und Augusta-Klinik Bochum, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6ren","family":"Gatermann","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Hygiene und Mikrobiologie, Abteilung Medizinische Mikrobiologie, Universit\u00e4tsklinikum der Ruhr-Universit\u00e4t Bochum, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stathis","family":"Phillipou","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Giesa","sequence":"additional","affiliation":[{"name":"Thoraxzentrum Ruhrgebiet, Kliniken f\u00fcr Pneumologie und Infektiologie, EVK Herne und Augusta-Klinik Bochum, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich","family":"Hecker","sequence":"additional","affiliation":[{"name":"Thoraxzentrum Ruhrgebiet, Kliniken f\u00fcr Thoraxchirurgie, EVK Herne, Herne, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,9,11]]},"reference":[{"key":"ref1","first-page":"501","article-title":"Pulmonary oxalosis caused by Aspergillus niger","volume":"129","author":"J B Metzger","year":"1984","journal-title":"Am Rev Respir Dis"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1378\/chest.101.3.870","article-title":"Invasive Aspergillus niger with fatal pulmonary oxalosis in chronic obstructive pulmonary disease","volume":"101","author":"E A Kimmerling","year":"1992","journal-title":"Chest"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s101560050016","article-title":"Aspergillus niger pneumonia with fatal pulmonary oxalosis","volume":"5","author":"Y Nakagawa","year":"1999","journal-title":"J Infect Chemother"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1099\/jmm.0.018309-0","article-title":"Aspergillus niger: an unusual cause of invasive pulmonary aspergillosis","volume":"59","author":"A K Person","year":"2010","journal-title":"J Med Microbiol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"153","DOI":"10.5603\/ARM.2020.0090","article-title":"Pulmonary oxalosis in pulmonary aspergillosis syndrome","volume":"88","author":"O S Osholowu","year":"2020","journal-title":"Adv Respir Med"},{"key":"ref6","first-page":"101503","article-title":"A rare case of invasive pulmonary aspergillosis presenting as organizing pneumonia due to Aspergillus niger in an immunocompetent host","volume":"34","author":"R Schils","year":"2021","journal-title":"Respir Med Case Rep"},{"key":"ref7","first-page":"101367","article-title":"Fatal VAP-related pulmonary aspergillosis by Aspergillus niger in a positive COVID-19 patient","volume":"32","author":"L Trovato","year":"2021","journal-title":"Respir Med Case Rep"},{"key":"ref8","first-page":"101641","article-title":"Acute respiratory failure due to Aspergillus niger infection with acute fibrinous and organizing pneumonia: A case report","volume":"37","author":"K Okamura","year":"2022","journal-title":"Respir Med Case Rep"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1056\/NEJMra2027424","article-title":"Aspergillus infection","volume":"385","author":"GP Thompson III","year":"2021","journal-title":"N Engl J Med"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/00005792-200007000-00006","article-title":"Invasive aspergillosis. 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