Aerosolized amphotericin for the treatment of allergic bronchopulmonary aspergillosis.
Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction to Aspergillus fumigatus that occur frequently in patients with cystic fibrosis (CF). Recurrent episodes of bronchial obstruction, inflammation, and mucoid impaction occur in ABPA and results in bronchiectasis, fibrosis, and respiratory failure. The treatment of ABPA includes corticosteroids to reduce the acute inflammation and intraconazole to reduce the fungal colonization load in order to reduce lung injury. This case discusses the successful use of aerosolized amphotericin B for the treatment of ABPA in a 14-year-old patient with CF listed for lung transplant. The patient required fewer hospitalizations, and both oral corticosteroids and anti-fungal therapy were eventually stopped.
Hayes
Don
D
Department of Pediatrics, University of Kentucky College of Medicine, C424 University of Kentucky Medical Center, Lexington, KY, USA. don.hayes@uky.edu
Murphy
Brian S
BS
Lynch
James E
JE
Feola
David J
DJ
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000276:immunology / Q000627:therapeutic use; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D001232:Aspergillus fumigatus / Q000187:drug effects* / Q000276:immunology / Q000302:isolation & purification; D001987:Bronchiectasis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D003550:Cystic Fibrosis / Q000235:genetics / Q000276:immunology / Q000382:microbiology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D017964:Itraconazole / Q000276:immunology / Q000627:therapeutic use; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D013183:Sputum / Q000276:immunology / Q000382:microbiology
D000305:Adrenal Cortex Hormones; D000935:Antifungal Agents; D007074:Immunoglobulin G; D017964:Itraconazole; D007073:Immunoglobulin E; D000666:Amphotericin B