[肺曲菌球的术前抗真菌药物]

[Preoperative antifungal agent for pulmonary aspergilloma].

作者信息

Fujiwara K, Chihara K, Yamashina A

机构信息

Department of Thoracic Surgery, Shizuoka Fuji National Hospital, Fujinomiya, Japan.

出版信息

Kyobu Geka. 2006 Dec;59(13):1186-90.

PMID:17163212

Abstract

A 52-year-old man with a 6-month history of bloody sputum was admitted to our hospital. Chest X-ray on admission showed a pulmonary cavity with liquid content in the left upper field and consolidation at the circumference of the lesion. Chest computed tomography (CT) on the 13th hospital day revealed a typical fungus ball in the cavity, which we diagnosed as pulmonary aspergilloma. We administered him micafungin sodium for 1 month. Voriconazole was administered subsequently, but side effects developed. Therefore, itraconazole was administered as a substitute. Chest high-resolution CT (HRCT) clearly showed a reduction in size of the aspergilloma, thus confirming the effectiveness of antifungal agent administration in this case. However, since hemoptysis occurred for the case, left upper lobectomy was performed and postoperative course was excellent.

摘要

一名有6个月咯血病史的52岁男性入住我院。入院时胸部X线显示左上肺野有一个含液性成分的肺空洞，病变周边有实变。入院第13天的胸部计算机断层扫描（CT）显示空洞内有一个典型的真菌球，我们诊断为肺曲菌球。我们给他使用米卡芬净钠治疗1个月。随后给予伏立康唑，但出现了副作用。因此，改用伊曲康唑。胸部高分辨率CT（HRCT）清楚地显示曲菌球体积缩小，从而证实了本例抗真菌药物治疗的有效性。然而，由于该病例发生了咯血，遂行左上肺叶切除术，术后恢复良好。