Effect of azithromycin on bronchiectasis and pulmonary function in a heart-lung transplant patient with severe chronic allograft dysfunction: a case report.
Azithromycin has been shown to be beneficial in several diseases with chronic neutrophilic inflammation of the airways, such as cystic fibrosis and bronchiolitis obliterans syndrome (BOS) after lung transplantation. Up to now, however, its healing effect on bronchiectasis has never been demonstrated. We report a heart-lung transplant patient who developed chronic rejection (BOS stage 3) with the appearance of gross bronchiectasis on a spiral computed tomography (CT) chest scan. Within 2 weeks after starting azithromycin, the patient's forced expiratory volume in 1 second increased significantly and a repeat spiral CT chest scan 5 months later, showed a major improvement of the bronchiectasis. This case report illustrates that bronchiectasis may greatly improve after treatment with azithromycin and no longer needs to be considered an endstage finding in patients with severe BOS.
Verleden
Geert M
GM
Department of Respiratory Diseases, University Hospital Gasthuisberg, Leuven, Belgium. geert.verleden@uz.kuleuven.ac.be
Dupont
Lieven J
LJ
Vanhaecke
Johan
J
Daenen
Willem
W
Van Raemdonck
Dirk E M
DE
D000293:Adolescent; D017963:Azithromycin / Q000008:administration & dosage*; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004541:Eisenmenger Complex / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control*; D016041:Heart-Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010101:Oxygen Consumption / Q000502:physiology; D011659:Pulmonary Gas Exchange; D011859:Radiography; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D017963:Azithromycin