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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.

Fatal hemoptysis from invasiveAspergillus nigerin a patient with cavitary lung disease andMycobacterium avium complexinfection