两性霉素B治疗看似成功后肺毛霉病中持续存在的空洞

Persistent cavitations in pulmonary mucormycosis after apparently successful amphotericin B.

作者信息

Donado-Uña José R, Díaz-Hellín Vicente, López-Encuentra Angel, Echave-Sustaeta José M

机构信息

Department of Pulmonology, Hospital Doce de Octubre, Carretera de Andalucía km 5.4, CP 28041 Madrid, Spain.

出版信息

Eur J Cardiothorac Surg. 2002 May;21(5):940-2. doi: 10.1016/s1010-7940(02)00081-7.

DOI:10.1016/s1010-7940(02)00081-7

PMID:12062298

Abstract

A 67-year-old diabetic male developed bilateral pulmonary mucormycosis (PM). After long-term treatment with amphotericin B (cumulative dose of 30.6 g), clinical resolution was obtained, but small radiographic cavitations persisted. A late relapse occurred and bilateral lobectomy led to a definitive cure. Amphotericin B is not able to penetrate properly into PM cavitations. We suggest that persistence of cavitations should lead to consideration of surgery, even after a good response to amphotericin B.

摘要

一名67岁的糖尿病男性患双侧肺毛霉菌病（PM）。在用两性霉素B长期治疗（累积剂量30.6g）后，临床症状得到缓解，但影像学上的小空洞仍然存在。随后出现晚期复发，双侧肺叶切除术带来了根治效果。两性霉素B无法有效渗透到PM空洞中。我们建议，即使在对两性霉素B有良好反应后，空洞持续存在也应考虑手术治疗。