title: Endobronchial cryotherapy for a mycetoma.
abstract: Mycetoma is defined as a fungus ball that fills a preexisting lung cavity, most frequently being of tuberculous or sarcoid etiology. The most frequently isolated fungus is the species of Aspergillus, but other fungi such as Fusarium or Zygomycetes can also be present. Most patients lack symptoms. However, presentation may also be with hemoptysis, which can be massive and life-threatening. We describe the case of a 50-year-old man with a history of prior pulmonary tuberculosis, with recurrent episodes of cough and hemoptysis. He was diagnosed to have mycetoma in the left upper lobe cavity. The mycetoma was extracted through bronchoscopy under general anesthesia using a cryoprobe. Treatment was completed with amphotericin B instilled in the cavity and the patient was placed on oral itraconazole. This is the first case report to date in which cryotherapy was used to remove a mycetoma.
authors.affiliation: Department of Pulmonology Medicine, Hospital General Nuestra Señora del Prado, Talavera de la Reina, Toledo, Spain.
authors.forename: Diego Germán
authors.initials: DG
authors.lastname: Rojas-Tula
authors.forename: Máximo
authors.initials: M
authors.lastname: Gómez-Fernández
authors.forename: José Javier
authors.initials: JJ
authors.lastname: García-López
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Cobos-Ceballos
authors.forename: América
authors.initials: A
authors.lastname: Gil-Fuentes
authors.forename: Jesús Manuel
authors.initials: JM
authors.lastname: Pérez-Laya
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Serrano-Rebollo
authors.forename: Angel
authors.initials: A
authors.lastname: Ortega-González
authors.forename: Teresa
authors.initials: T
authors.lastname: Vargas-Hidalgo
authors.forename: José María
authors.initials: JM
authors.lastname: Ruíz de Oña-Lacasta
authors.forename: José
authors.initials: J
authors.lastname: Celdrán-Gil
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001999:Bronchoscopy / Q000379:methods*; D003371:Cough / Q000000981:diagnostic imaging / Q000628:therapy; D017679:Cryotherapy / Q000379:methods*; D060585:Fusariosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D006801:Humans; D007322:Instillation, Drug; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008271:Mycetoma / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011859:Radiography; D012008:Recurrence; D014397:Tuberculosis, Pulmonary / Q000150:complications
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B