title: Chronic necrotizing pulmonary aspergillosis successfully diagnosed, treated, and followed by ultrathin bronchoscope.
abstract: We present a case of chronic necrotising pulmonary aspergillosis (CNPA) successfully diagnosed, treated and followed by ultrathin bronchoscope. A 68-year-old man was admitted to the hospital because of a cough and low-grade fever. A chest computerized tomography (CT) showed cavitary infiltrates in the superior segment of the left upper lobe. Bronchoscopic examination was performed using a 2.8-mm ultrathin bronchoscope, which could be inserted into the cavity lesion under direct vision. Biopsy specimens from a whitish intracavity lesion showed septate-branching hyphae and cultures of the cavital washing grew Aspergillus fumigatus. Using the ultrathin bronchoscope, we instilled amphotericin B into the cavity before oral itraconazole therapy. The patient showed clinical improvement with resolution of the cavitary infiltrates on CT findings. The whitish intracavity lesion had prominently disappeared after 18 months of therapy. An ultrathin bronchoscope is useful for treating and assessing cavity lesions as well as establishing a diagnosis for CNPA patients.
authors: Yutaro
authors: Y
authors: Nakamura
authors: Masahiro
authors: M
authors: Shirai
authors: Hiroshi
authors: H
authors: Hayakawa
authors: Yasukatsu
authors: Y
authors: Nakano
authors: Kaoru
authors: K
authors: Fujita
authors: Takafumi
authors: T
authors: Suda
authors: Kingo
authors: K
authors: Chida
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D001706:Biopsy; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000379:methods*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B