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. 1996 Mar;51(3):253–255. doi: 10.1136/thx.51.3.253

Topical treatment of life threatening haemoptysis from aspergillomas.

M Rumbak 1, G Kohler 1, C Eastrige 1, H Winer-Muram 1, M Gavant 1
PMCID: PMC1090634  PMID: 8779126

Abstract

BACKGROUND: The efficacy of topical treatment of 12 episodes of severe life threatening haemoptysis from a pulmonary aspergilloma in 11 patients is reviewed. METHODS: A retrospective review was performed on five white and six African-American patients of mean age 49 years. The underlying diseases were bronchiectasis, sarcoidosis, tuberculosis, or histoplasmosis. The patients were prospectively considered poor surgical risks because they had a forced expiratory volume in one second (FEV1) of < 50% predicted and an arterial oxygen tension (PaO2) of < 7.95 kPa breathing room air. As surgical intervention was not possible, local intracavitary instillation of sodium or potassium iodide was performed. Two patients were previously treated with amphotericin B. In one patient sodium iodide alone was used and in the remaining eight potassium iodide alone was instilled. The transcricothyroid approach was used in six patients and the percutaneous approach in five. RESULTS: Haemoptysis ceased within 72 hours in all patients after the instillation of sodium or potassium iodide. There was no morbidity or mortality, and side effects included slight irritation on instillation of the iodide solution and occasional cough which was easily controlled. All patients were alive at least one year later. CONCLUSION: Intracavitary treatment is a viable option in the poor risk patient with life threatening haemoptysis from an aspergilloma.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adelson H. T., Malcolm J. A. Endocavitary treatment of pulmonary mycetomas. Am Rev Respir Dis. 1968 Jul;98(1):87–92. doi: 10.1164/arrd.1968.98.1.87. [DOI] [PubMed] [Google Scholar]
  2. CAMPBELL M. J., CLAYTON Y. M. BRONCHOPULMONARY ASPERGILLOSIS. A CORRELATION OF THE CLINICAL AND LABORATORY FINDINGS IN 272 PATIENTS INVESTIGATED FOR BRONCHOPULMONARY ASPERGILLOSIS. Am Rev Respir Dis. 1964 Feb;89:186–196. doi: 10.1164/arrd.1964.89.2.186. [DOI] [PubMed] [Google Scholar]
  3. Eastridge C. E., Young J. M., Cole F., Gourley R., Pate J. W. Pulmonary aspergillosis. Ann Thorac Surg. 1972 Apr;13(4):397–403. doi: 10.1016/s0003-4975(10)64872-2. [DOI] [PubMed] [Google Scholar]
  4. Fernandez N. A. Intracavitary aminocaproic acid for massive pulmonary hemorrhage. Chest. 1984 Jun;85(6):839–839. doi: 10.1378/chest.85.6.839a. [DOI] [PubMed] [Google Scholar]
  5. Glimp R. A., Bayer A. S. Pulmonary aspergilloma. Diagnostic and therapeutic considerations. Arch Intern Med. 1983 Feb;143(2):303–308. doi: 10.1001/archinte.143.2.303. [DOI] [PubMed] [Google Scholar]
  6. Hamamoto T., Watanabe K., Ikemoto H. Endobronchial miconazole for pulmonary aspergilloma. Ann Intern Med. 1983 Jun;98(6):1030–1030. doi: 10.7326/0003-4819-98-6-1030_1. [DOI] [PubMed] [Google Scholar]
  7. Hammerman K. J., Sarosi G. A., Tosh F. E. Amphotericin B in the treatment of saprophytic forms of pulmonary aspergillosis. Am Rev Respir Dis. 1974 Jan;109(1):57–62. doi: 10.1164/arrd.1974.109.1.57. [DOI] [PubMed] [Google Scholar]
  8. Hilvering C., Stevens E. A., Orie N. G. Fever in aspergillus mycetoma. Thorax. 1970 Jan;25(1):19–24. doi: 10.1136/thx.25.1.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Israel H. L., Lenchner G. S., Atkinson G. W. Sarcoidosis and aspergilloma. The role of surgery. Chest. 1982 Oct;82(4):430–432. doi: 10.1378/chest.82.4.430. [DOI] [PubMed] [Google Scholar]
  10. Jackson M., Flower C. D., Shneerson J. M. Treatment of symptomatic pulmonary aspergillomas with intracavitary instillation of amphotericin B through an indwelling catheter. Thorax. 1993 Sep;48(9):928–930. doi: 10.1136/thx.48.9.928. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Jewkes J., Kay P. H., Paneth M., Citron K. M. Pulmonary aspergilloma: analysis of prognosis in relation to haemoptysis and survey of treatment. Thorax. 1983 Aug;38(8):572–578. doi: 10.1136/thx.38.8.572. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Krakówka P., Traczyk K., Walczak J., Halweg H., Elsner Z., Pawlicka L. Local treatment of aspergilloma of the lung with a paste containing nystatin or amphotericin B. Tubercle. 1970 Jun;51(2):184–191. doi: 10.1016/0041-3879(70)90071-1. [DOI] [PubMed] [Google Scholar]
  13. RAMIREZ J. PULMONARY ASPERGILLOMA: ENDOBRONCHIAL TREATMENT. N Engl J Med. 1964 Dec 17;271:1281–1285. doi: 10.1056/NEJM196412172712502. [DOI] [PubMed] [Google Scholar]
  14. Shapiro M. J., Albelda S. M., Mayock R. L., McLean G. K. Severe hemoptysis associated with pulmonary aspergilloma. Percutaneous intracavitary treatment. Chest. 1988 Dec;94(6):1225–1231. doi: 10.1378/chest.94.6.1225. [DOI] [PubMed] [Google Scholar]

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