[Therapeutic alternatives in complicated nonsurgical pulmonary aspergillomas].
We present 2 patients with pulmonary aspergilloma complicated by massive hemoptysis who were not good candidates for surgery and were treated with intracavitary amphotericin B after arterial embolization failed. In spite of the size of the mycetomas, response to treatment was excellent with full regression of the aspergilloma after 3 to 4 weeks; precipitins to Aspergillus fumigatus became negative and the fungus disappeared from transcatheter aspirate samples. Massive hemoptysis was controlled with epsilon-amino-caproic acid instilled by catheter. No complications were observed, the treatment was well tolerated and no recurrence occurred over a follow-up period of 24 and 18 months, respectively. This local treatment is the best therapeutic alternative for patients with pulmonary aspergilloma who are not candidates for surgery.
Ortiz de Saracho
J
J
Servicio de Neumología, Hospital Ramón y Cajal, Madrid.
Pérez-Rodríguez
E
E
Zapatero
J
J
Sánchez
J
J
Navío
P
P
Flores
J
J
D015119:Aminocaproic Acid / Q000008:administration & dosage*; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D001228:Aspergillosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002404:Catheterization; D004361:Drug Tolerance; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008172:Lung Diseases, Fungal / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013997:Time Factors
D000666:Amphotericin B; D015119:Aminocaproic Acid