Localized Endotracheal Oxalosis Probably Secondary to Aspiration of Rhubarb

Abstract

To the Editor.— An elderly debilitated patient was found at autopsy to have a fragment of vegetable matter impacted on the tracheal mucosa, which, with the underlying wall, was necrotic and contained large amounts of oxalate crystals. Oxalate was also present in the vegetable matter. It is probable that the aspirated material was rhubarb, which contains large amounts of oxalate. The case illustrates the ability of oxalate to produce tissue injury. Oxalosis, or excess deposition of calcium oxalate crystals in various tissues, has been observed in association with enzymatic, nutritional, or metabolic derangements in which excess oxalate is produced, or with increased ingestion of oxalate or oxalate precursors such as ethylene glycol.1It may occur with renal failure and decreased excretion of oxalate, and it has been produced by fungus.2When the oxalate is systemic, calcium oxalate crystals are frequently seen in the kidney, may occur in myocardium