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Section of General Internal Medicine, Section of Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. alex.h.gifford@hitchcock.org
Invasive aspergillosis typically afflicts immunocompromised patients, whereas pulmonary aspergilloma is a recognized complication of pre-existing cavitary lung disease in immunocompetent hosts. In both cases, the most prevalent pathogens are Aspergillus fumigatus and Aspergillus flavus. We describe a case of fatal hemoptysis from invasive Aspergillus niger infection in the setting of bullous lung disease, steroid-treated sarcoidosis, and Mycobacterium avium complex infection. This report highlights the potential for A. niger to cause invasive disease in conjunction with other pathologic processes in the lung.
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