Discussion:  Esophageal-pleural fistulas are uncommon and the majority are associated with malignancy, previous esophageal instrumentation or surgery, or a rare complication post-pneumonectomy.  In this case, no primary cause was found.  

Pleural fluid aspirated during CT guided drainage was noted to be unusually black in color and cultures grew Candida krusei and Saccharomyces cerevisiae.  Interestingly, Candida krusei is a budding yeast used in chocolate production and Saccharomyces cerevisiae in winemaking, baking and brewing.  The patient made slow improvement on IV antifungals and a left thoracotomy and pleural space decortication was performed.