Persistent cavitations in pulmonary mucormycosis after apparently successful amphotericin B.
A 67-year-old diabetic male developed bilateral pulmonary mucormycosis (PM). After long-term treatment with amphotericin B (cumulative dose of 30.6 g), clinical resolution was obtained, but small radiographic cavitations persisted. A late relapse occurred and bilateral lobectomy led to a definitive cure. Amphotericin B is not able to penetrate properly into PM cavitations. We suggest that persistence of cavitations should lead to consideration of surgery, even after a good response to amphotericin B.
Donado-Uña
José R
JR
Department of Pulmonology, Hospital Doce de Octubre, Carretera de Andalucía km 5.4, CP 28041 Madrid, Spain. jrdonado@arrakis.es
Díaz-Hellín
Vicente
V
López-Encuentra
Angel
A
Echave-Sustaeta
José M
JM
D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D025141:Drug Resistance, Fungal; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D009091:Mucormycosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D000666:Amphotericin B