title: Multiple bilateral pulmonary "fungus balls" in an immunocompetent patient unsuitable for surgical treatment: efficacy of azoles treatment.
abstract: Data guiding management of pulmonary mycetomas are based on uncontrolled trials and case reports. Surgical resection represents a definitive treatment associated with high mortality and sometimes not feasible due to clinical conditions. We report a case of an immunocompetent patient with multiple pulmonary mycetomas, suggestive for probable chronic aspergillosis, in which surgery was contraindicated. The patient experienced a good response to long-term oral voriconazole therapy with remarkable clinical and radiological improvement at three-month follow-up. In cases of probable chronic aspergillomas, when surgery is contraindicated, long-term antifungal therapy with voriconazole seems to be a valid alternative option.
authors.affiliation: 2nd Division, National Institute for Infectious Diseases L. Spallanzani, Rome, Italy. alessandro.capone@inmi.it
authors.forename: A
authors.initials: A
authors.lastname: Capone
authors.forename: S
authors.initials: S
authors.lastname: Di Bella
authors.forename: P
authors.initials: P
authors.lastname: Chinello
authors.forename: D
authors.initials: D
authors.lastname: Chiappetta
authors.forename: C
authors.initials: C
authors.lastname: Campoli
authors.forename: N
authors.initials: N
authors.lastname: Petrosillo
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008271:Mycetoma / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D055732:Pulmonary Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D011743:Pyrimidines / Q000008:administration & dosage*; D011859:Radiography; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole