[Successful therapy of pulmonary aspergillosis in a patient with non-Hodgkin lymphoma].
ANAMNESIS AND CLINICAL PICTURE: A 65-year old male with non-Hodgkin lymphoma developed severe invasive pulmonary aspergillosis during a state of leucopenia after chemotherapy.


METHODS
The initial manifestation was an infiltration in the right upper lobe of the lung, identified by lung scintigraphy as a peripheral wedge-shaped loss of perfusion. Both serum and bronchoalveolar lavage extreme high titre of Aspergillus antigen were seen as a laboratory indication of an invasive aspergillosis. The mould Aspergillus fumigatus was repeatedly isolated from bronchoalveolar lavage and bronchial secretion.


METHODS
Treatment was started with amphotericin B plus 5-flucytosine together with repeatedly bronchoscopic instillation of miconazole followed by thoracosurgical intervention with resection of the right upper lobe of the lung. Despite prophylaxis by itraconazole, a relapse of invasive aspergillosis occurred three months later probably due to persistence of aspergillus fungal elements in the left lung. The aspergillosis relapse was treated at first with liposomal amphotericin B. After eighteen days of treatment this was changed to a combination of 5-flucytosine with oral application of itraconazole, and cure was achieved.
Nenoff
P
P
Klinik und Poliklinik für Hautkrankheiten Universität Leipzig.
Winkler
J
J
Horn
L C
LC
Haupt
R
R
D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001228:Aspergillosis / Q000276:immunology / Q000628:therapy*; D001232:Aspergillus fumigatus / Q000276:immunology; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D006801:Humans; D007108:Immune Tolerance / Q000187:drug effects; D008172:Lung Diseases, Fungal / Q000276:immunology / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000276:immunology*; D008297:Male; D009894:Opportunistic Infections / Q000276:immunology / Q000628:therapy*; D011013:Pneumonectomy
D000935:Antifungal Agents
Erfolgreiche Therapie einer pulmonalen Aspergillose bei einem Patienten mit Non-Hodgkin-Lymphom.