Chronic necrotizing pulmonary aspergillosis treated by endobronchial amphotericin B.
Chronic necrotizing pulmonary aspergillosis is an indolent, locally invasive form of Aspergillus infection. Treatment options are limited and controversial. Resection is often curative if the patient has sufficient ventilatory reserve. Even though intravenous amphotericin B is effective in a few patients, toxicity limits its use. Aerosolized amphotericin B has proven ineffective. Anecdotal reports of intracavitary and endobronchial antifungal therapy show limited success. Our patient had unresectable chronic necrotizing pulmonary aspergillosis treated successfully with intracavitary instillation of amphotericin B, delivered via the flexible fiberoptic bronchoscope.
Department of Internal Medicine, Western Pennsylvania Hospital, Pittsburgh 15224.
M R
MR
Bennett
D L
DL
Weinbaum
P C
PC
Fiehler
D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D001228:Aspergillosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D001999:Bronchoscopy; D002908:Chronic Disease; D006801:Humans; D007263:Infusions, Parenteral; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011859:Radiography
D000666:Amphotericin B