Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1993 Sep;48(9):928–930. doi: 10.1136/thx.48.9.928

Treatment of symptomatic pulmonary aspergillomas with intracavitary instillation of amphotericin B through an indwelling catheter.

M Jackson 1, C D Flower 1, J M Shneerson 1
PMCID: PMC464780  PMID: 8236077

Abstract

BACKGROUND--The treatment of symptomatic pulmonary aspergillomas can be difficult. One approach has been to deliver antifungal drugs directly into the lung cavity. The use of this method of treatment is described in which an indwelling percutaneous catheter is used which avoids repeated needlings of the cavity and may allow extended treatment on a domiciliary basis. METHODS--Amphotericin B was delivered through indwelling percutaneous intracavitary catheters to treat five symptomatic episodes in four patients with pulmonary aspergillomas. RESULTS--The treatment was well tolerated by all patients and their symptoms resolved in four of the five episodes. Two patients died, one from an unrelated bronchopneumonia and the other from advanced cachexia. Two patients remain symptom free after eight and 12 months. CONCLUSIONS--Intracavitary administration of amphotericin through an indwelling catheter should be considered for any patient who has troublesome sputum production, haemoptysis, or systemic symptoms attributable to an aspergilloma.

Full text

PDF

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 J. H., Winter J. H., Richardson M. D., Shankland G. S., Banham S. W. Treatment of pulmonary aspergilloma with itraconazole. Thorax. 1991 Nov;46(11):839–841. doi: 10.1136/thx.46.11.839. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. 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]
  4. 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]
  5. Hargis J. L., Bone R. C., Stewart J., Rector N., Hiller F. C. Intracavitary amphotereicin B in the treatment of symptomatic pulmonary aspergillomas. Am J Med. 1980 Mar;68(3):389–394. doi: 10.1016/0002-9343(80)90109-6. [DOI] [PubMed] [Google Scholar]
  6. 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]
  7. 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]
  8. RAMIREZ J. PULMONARY ASPERGILLOMA: ENDOBRONCHIAL TREATMENT. N Engl J Med. 1964 Dec 17;271:1281–1285. doi: 10.1056/NEJM196412172712502. [DOI] [PubMed] [Google Scholar]
  9. 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]
  10. Shneerson J. M., Emerson P. A., Phillips R. H. Radiotherapy for massive haemoptysis from an aspergilloma. Thorax. 1980 Dec;35(12):953–954. doi: 10.1136/thx.35.12.953. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Varkey B., Rose H. D. Pulmonary aspergilloma. A rational approach to treatment. Am J Med. 1976 Nov;61(5):626–631. doi: 10.1016/0002-9343(76)90140-6. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES