支气管内注射两性霉素B治疗慢性坏死性肺曲霉病

Chronic necrotizing pulmonary aspergillosis treated by endobronchial amphotericin B.

作者信息

Bennett M R, Weinbaum D L, Fiehler P C

机构信息

Department of Internal Medicine, Western Pennsylvania Hospital, Pittsburgh 15224.

出版信息

South Med J. 1990 Jul;83(7):829-32. doi: 10.1097/00007611-199007000-00025.

DOI:10.1097/00007611-199007000-00025

PMID:2196695

Abstract

Chronic necrotizing pulmonary aspergillosis is an indolent, locally invasive form of Aspergillus infection. Treatment options are limited and controversial. Resection is often curative if the patient has sufficient ventilatory reserve. Even though intravenous amphotericin B is effective in a few patients, toxicity limits its use. Aerosolized amphotericin B has proven ineffective. Anecdotal reports of intracavitary and endobronchial antifungal therapy show limited success. Our patient had unresectable chronic necrotizing pulmonary aspergillosis treated successfully with intracavitary instillation of amphotericin B, delivered via the flexible fiberoptic bronchoscope.

摘要

慢性坏死性肺曲霉病是一种进展缓慢、局部侵袭性的曲霉感染形式。治疗选择有限且存在争议。如果患者有足够的通气储备，手术切除通常可治愈。尽管静脉注射两性霉素B对少数患者有效，但毒性限制了其使用。雾化吸入两性霉素B已被证明无效。腔内和支气管内抗真菌治疗的个案报道显示成功率有限。我们的患者患有无法手术切除的慢性坏死性肺曲霉病，通过可弯曲纤维支气管镜进行腔内注入两性霉素B成功治愈。