SAPROPHYTIC INVASION OF INFARCTED PULMONARY TISSUE BY ASPERGILLUS SPECIES

Saprophytic invasion of infarcted pulmonary tissue has received only passing reference in published reports. Five patients with colonization of pulmonary infarcts by aspergillus are described, with discussion of the clinical and histopathological features. The characteristic features were widespread invasion of dead tissue by fungal hyphae, in 3 cases with liquefaction resulting in the production of a cavitated lesion. There was no evidence that the vascular thrombosis and the consequent infarction present in 4 cases were caused by the fungus. In 2 cases the lesions were resected as possible peripheral cavitated tumors, and in 2 they were incidental findings at necropsy in patients who had had carcinoma and received radiotherapy. In the 5th case the clinical diagnosis was pneumococcal pneumonia but the possibility of primary aspergillus pneumonia was raised.