title: Salvage therapy with topical antifungal for Aspergillus fumigatus empyema complicating extrapleural pneumonectomy.
abstract: We describe an unusual case of Aspergillus fumigatus empyema and bronchopleural fistulae after extrapleural pneumonectomy (EPP) and chemoradiotherapy (CRT), which was treated successfully under salvage conditions with debridement, an innovative topical antifungal application and supplemented systemic antifungal therapy and which went on for a definitive surgical procedure. Combinations of CRT and EPP have been recommended in a select group of patients with malignant mesothelioma. Irrespective of the combination, EPP is associated with mortality in the range of 4-15% and a complication rate as high as 62%.
authors.affiliation: Department of Cardiothoracic Surgery, Lancashire Cardiac Centre, Blackpool Teaching Hospital NHS Foundation Trust, Blackpool, UK. drpurohitm@yahoo.com
authors.forename: Manoj
authors.initials: M
authors.lastname: Purohit
authors.forename: Achyut
authors.initials: A
authors.lastname: Guleri
authors.forename: Joseph
authors.initials: J
authors.lastname: Zacharias
mesh_terms: D000287:Administration, Topical; D000935:Antifungal Agents / Q000008:administration & dosage*; D001228:Aspergillosis / Q000382:microbiology / Q000628:therapy*; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D004653:Empyema / Q000382:microbiology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000601:surgery; D011013:Pneumonectomy / Q000379:methods*; D016879:Salvage Therapy / Q000379:methods*; D013530:Surgical Wound Infection / Q000382:microbiology / Q000628:therapy; D035441:Thoracic Wall
chemical_list: D000935:Antifungal Agents