Black Pleural Effusion Reply
Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan. Electronic address: .The American journal of medicine (Impact Factor: 5). 04/2013; 126(12). DOI: 10.1016/j.amjmed.2012.11.017
Black pleural effusions are extremely rare and have been reported in patients with infection, malignancy, and hemorrhage. However, no review article has focused on this rare clinical presentation. Previous reports of black pleural effusions were reviewed, and the underlying diseases were classified into 4 entities based on the pathophysiological conditions: infection (Aspergillus niger and Rhizopus oryzae); malignant melanoma, in which cells contain melanin pigment; hemorrhage and hemolysis associated with non-small-cell lung cancer or rupture of a pancreatic pseudocyst; and other cause (charcoal-containing empyema). The differences also were discussed, with special reference to distinguishing between biliopleural fistula and pancreaticopleural fistula, which mimic the color but should be discriminated due to their different management.
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ABSTRACT: Several studies have shown that some microbes and fungi contaminate sea water. We conducted this study to investigate and identify bacterial and fungal species in Red Sea near Jeddah, Saudi Arabia. Water and sand samples were collected in March 2012 via sterile screw cap bottles and isolated using nutrient agar, Sabouraud agar, Glucose-Czapek and Petroleum oil-Czapek agars. Baterial sensitivity testing was done for bacterial isolates. There were a total of 18 fungal genera isolated. On Glucose-Czapek agar, including the genus Aspergillus and Penicillium. On Petroleum oil - Czapek agar, there were a total of six fungal genera that were isolated including Aspergillus and Penicillium. Bacterial isolates included Pseudomonas fuorescens, Pseudomonas putida, Pseudomonas stutzeri, Pasteurella multocida and Serratia species. Antibiotic susceptibility tests on bacterial species showed sensitivity to most antibiotics. There is a need to inform the public of the potential dangers of infection from contaminated sea water and sand. It is best to maintain good hygienic practices by immediately bathing in potable water after swimming or diving in the sea, which is a possible source of transmission route for fungi and bacteria.
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ABSTRACT: Discrimination between aspergilloma and chronic necrotizing pulmonary aspergillosis (CNPA) based on radiological findings can difficult. We describe a patient with aspergilloma and organizing pneumonia that was possibly caused by Aspergillus niger infection and radiologically mimicked CNPA. A postmortem histological analysis showed diffuse alveolar damage that had originated in peri-cavitary lung parenchyma. Calcium oxalate or Aspergillus niger was located inside, but not outside the cavity in the right upper lobe. Calcium oxalate or other unknown hyphal bioactive components might provoke severe lung inflammation not only adjacent to the cavity, but also on the contralateral side.
Article: Black Pleural Effusion
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