Effect of direct infusion of antifungal agent on invasive pulmonary aspergillosis in a patient with acute leukemia.
Invasive pulmonary aspergillosis is a serious problem in the treatment of patients with acute leukemia. A 52-year-old woman with acute myeloid leukemia developed invasive pulmonary aspergillosis during remission induction chemotherapy. Initially, we treated her with a continuous intravenous drip infusion of amphotericin B, together with itraconazole, given orally. A peripheral crescentic cavity formed in the fungal lesion after the number of neutrophils recovered, and we therefore performed a direct infusion of miconazole into the cavity transbronchially. The lung lesion resolved dramatically shortly after this treatment. In this patient, the transbronchial infusion of an antifungal agent seemed to have been very useful for bringing about prompt resolution of the fungal lesion.
Nakase
Kazunori
K
The Second Department of Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. k-nakase@amigo.ne.jp
Yazaki
Akira
A
Tamaki
Sigehisa
S
Tanigawa
Motoaki
M
Tsuji
Kota
K
Miyanishi
Eiki
E
Shiku
Hiroshi
H
D000666:Amphotericin B / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage*; D001228:Aspergillosis / Q000188:drug therapy* / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage*; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008172:Lung Diseases, Fungal / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B