Topical amphotericin B application in severe bronchial aspergillosis after lung transplantation: report of experiences in 3 cases.
Ulcerative tracheobronchial aspergillosis after lung transplantation (ltx) may lead to bronchial-pulmonary artery fistula that results in fatal bleeding. We report our early experience with combined systemic, aerolized and topical application of amphotericin B in 3 cases of bronchial aspergillosis after ltx. Two patients are still alive, but 1 died of bleeding from a fistula between the left upper lobe bronchus and the pulmonary artery. Aspergillosis in the second patient resolved with minimal stenosis of the left main and the left upper lobe bronchus, and the third patient developed an anastomotic stenosis that was successfully dilated.
Boettcher
H
H
Department of Cardiovascular Surgery, Kiel University Hospital, Kiel, Germany. hboettcher@kielheart.unikiel.de
Bewig
B
B
Hirt
S W
SW
Möller
F
F
Cremer
J
J
D000280:Administration, Inhalation; D000287:Administration, Topical; D000328:Adult; D000336:Aerosols; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000714:Anastomosis, Surgical / Q000009:adverse effects; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy*; D001980:Bronchi / Q000601:surgery; D001982:Bronchial Diseases / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D001983:Bronchial Fistula / Q000209:etiology; D003251:Constriction, Pathologic / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008172:Lung Diseases, Fungal / Q000188:drug therapy*; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000473:pathology; D016157:Vascular Fistula / Q000209:etiology
D000336:Aerosols; D000935:Antifungal Agents; D000666:Amphotericin B