Tsushima K, Fujimoto K, Kubo K, Sekiguchi M
First Department of Internal Medicine, Shinshu University School of Medicine, Nagano.
Intern Med. 1996 Sep;35(9):736-41. doi: 10.2169/internalmedicine.35.736.
A 53-year-old male of allergic bronchopulmonary aspergillosis (ABPA) with pulmonary fungus ball, who had been administered steroid and suffered repeatedly from dyspnea, was treated successfully with continuous percutaneous instillation of antifungal agents into the cavity. Although the pulmonary fungus ball in his left upper lobe was thought to be worsening ABPA, oral and intravenous antifungal agents failed to improve the clinical course. We selected to use continuous instillation of antifungal agents via an indwelling catheter which was inserted percutaneously into the cavity. Although the instillation of fluconazole (FCZ) for four weeks did not alter the process, two-week instillation of amphotericin B (AMPH) caused disappearance of the fungus ball. We measured the plasma concentration of FCZ and AMPH during their instillation into the cavity to ascertain this treatment to be free from side effects pharmacokinetically.
一名53岁患有变应性支气管肺曲霉病（ABPA）并伴有肺真菌球的男性患者，曾接受类固醇治疗且反复出现呼吸困难，通过经皮向空洞内持续滴注抗真菌药物成功治愈。尽管其左上叶的肺真菌球被认为是ABPA病情恶化的表现，但口服和静脉注射抗真菌药物均未能改善临床病程。我们选择通过经皮插入空洞内的留置导管持续滴注抗真菌药物。尽管滴注氟康唑（FCZ）四周并未改变病情，但滴注两性霉素B（AMPH）两周后真菌球消失。我们在向空洞内滴注FCZ和AMPH期间测量了它们的血浆浓度，从药代动力学角度确定这种治疗无副作用。
