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Can Long-term Antifungal Therapy Be an Alternative to Surgery in Pulmonary Aspergilloma?

Year 2018, Volume: 23 Issue: 3, 189 - 194, 26.09.2018
https://doi.org/10.21673/anadoluklin.413147

Abstract

Pulmonary aspergilloma is one of the clinical conditions with high mortality and morbidity
in immunosuppressed patients. Surgical resection has been the leading treatment option;
however, surgical treatment involves some risk of local and systemic dissemination and
there are also patients who are functionally inappropriate to be treated surgically. In this
paper, we present two patients with bilateral PA who underwent surgical and antifungal
treatment. Antifungal therapy with voriconazole that was successful for both of our patients
might be a promising approach to a group of PA patients who are not appropriate
for surgery

References

  • 1- Sagan D, Goździuk K. Surgery for pulmonary aspergilloma in immunocompetent patients: no benefit from adjuvant antifungal pharmacotherapy. Ann Thorac Surg. 2010 May;89(5):1603-10.
  • 2- Lee JG, Lee CY, Park IK, et al. Pulmonary aspergilloma: analysis of prognosis in relation to symptoms and treatment.J Thorac Cardiovasc Surg 2009;138:820 –5.
  • 3- Brik A, Salem AM, Kamal AR, et al. Surgical outcome of pulmonary aspergilloma. Eur J Cardiothorac Surg 2008;34: 882–5
  • 4- Park CK, Jheon S. Results of surgical treatment for pulmonary aspergilloma. Eur J Cardiothorac Surg 2002;21:918 –23.
  • 5- Campbell JH, Winter JH, Richardson MD, Shankland GS, Banham SW. Treatment of pulmonary aspergilloma with itraconazole. Thorax 1991;46:839–41.
  • 6- Seki M, Maesaki S, Hashiguchi K, et al. Aspergillus fumigatus isolated from blood samples of a patient with pulmonary aspergilloma after embolization. Intern Med 2000;39:188 –90.
  • 7- Jewkes J, Kay PH, Paneth M, Citron KM. Pulmonary aspergilloma: analysis of prognosis in relation to haemoptysis and survey of treatment. Thorax 1983;38:572– 8.
  • 8- Ho KM, Lipman J, Dobb GJ, Webb SA. The use of prophylactic fluconazole in immunocompetent high-risk surgical patients: a meta-analysis. Crit Care 2005;9:R710–7.
  • 9- Calandra T, Marchetti O. Clinical trials of antifungal prophylaxis among patients undergoing surgery. Clin Infect Dis 2004;39 (suppl 4):S185–92.
  • 10-. Scott SM, Takara T, Varkey B, et al: Thoracic mycotic and actinomycotic infections in General Thoracic Surgery: Ed: W.Shields; Williams and Wilkins, Baltimore,1994;986.
  • 11- British Thoracic and Tuberculosis Association: Aspergilloma and residual tuberculous cavities: the results of re-survey. Tubercle 1970;51:227– 45.
  • 12- Odev K. Toraks Radyolojisi kitabı, Genisletilmis¸ ikinci baskı. Nobel Tıp Kitapevleri. 2010;;214-215
  • 13- Jewkes J, Kay PH, Paneth M, Citron KM. Pulmonary aspergilloma: analysis of prognosis in relation to haemoptysis and survey of treatment. Thorax 1983;38:572– 8.
  • 14- el Oakley R, Petrou M, Goldstraw P. Indications and outcome of surgery for pulmonary aspergilloma. Thorax 1997; 52:813–5.
  • 15- Herbrecht R, Denning DW, Patterson TF et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis N Engl J Med 2002;347(6):408-15.
  • 16- Babatasi G, Massetti M, Chapelier A, et al. Surgical treatment of pulmonary aspergilloma: current outcome. J Thorac Cardiovasc Surg 2000; 906-12.
  • 17- Regnard JF, Icard P, Nicolasi M, et al. Aspergilloma: a series of 89 surgical cases. Ann Thorac Surg 2000; 69:898-903.
  • 18- Daly RC, Pairolero PC, Piehler JM, et al. Pulmonary aspergilloma: results of treatment . J Thorac Cardiovasc Surg 1986; 92: 981-8
  • 19- Battaglini JW, Murray GF, Kaegy BA, et al. Surgical management of symptomatic pulmonary aspergilloma. Ann Thorac Surg 1985;39:512-6

Pulmoner Aspergillomada Uzun Dönem Antifungal Tedavi Cerrahiye Alternatif Olabilir mi?

Year 2018, Volume: 23 Issue: 3, 189 - 194, 26.09.2018
https://doi.org/10.21673/anadoluklin.413147

Abstract

Pulmoner aspergilloma (PA), immünsüprese hastalarda yüksek mortalite ve morbiditeli
klinik durumlardandır. Tedavide sıklıkla cerrahi rezeksiyon tercih edilir; fakat cerrahide lokal
ve sistemik yayılım riski mevcuttur ve ayrıca cerrahi tedaviye fonksiyonel olarak uygun
olmayan hastalar da vardır. Bu çalışmada cerrahi ve antifungal tedavi uygulanmış olan
bilateral PA’lı iki hastayı sunmaktayız. Vorikonazol ile yapılan ve iki hastamızda da başarılı
olan antifungal tedavi, cerrahiye uygun olmayan bir grup PA hastası için ümit verici bir
yaklaşım olabilir. 

References

  • 1- Sagan D, Goździuk K. Surgery for pulmonary aspergilloma in immunocompetent patients: no benefit from adjuvant antifungal pharmacotherapy. Ann Thorac Surg. 2010 May;89(5):1603-10.
  • 2- Lee JG, Lee CY, Park IK, et al. Pulmonary aspergilloma: analysis of prognosis in relation to symptoms and treatment.J Thorac Cardiovasc Surg 2009;138:820 –5.
  • 3- Brik A, Salem AM, Kamal AR, et al. Surgical outcome of pulmonary aspergilloma. Eur J Cardiothorac Surg 2008;34: 882–5
  • 4- Park CK, Jheon S. Results of surgical treatment for pulmonary aspergilloma. Eur J Cardiothorac Surg 2002;21:918 –23.
  • 5- Campbell JH, Winter JH, Richardson MD, Shankland GS, Banham SW. Treatment of pulmonary aspergilloma with itraconazole. Thorax 1991;46:839–41.
  • 6- Seki M, Maesaki S, Hashiguchi K, et al. Aspergillus fumigatus isolated from blood samples of a patient with pulmonary aspergilloma after embolization. Intern Med 2000;39:188 –90.
  • 7- Jewkes J, Kay PH, Paneth M, Citron KM. Pulmonary aspergilloma: analysis of prognosis in relation to haemoptysis and survey of treatment. Thorax 1983;38:572– 8.
  • 8- Ho KM, Lipman J, Dobb GJ, Webb SA. The use of prophylactic fluconazole in immunocompetent high-risk surgical patients: a meta-analysis. Crit Care 2005;9:R710–7.
  • 9- Calandra T, Marchetti O. Clinical trials of antifungal prophylaxis among patients undergoing surgery. Clin Infect Dis 2004;39 (suppl 4):S185–92.
  • 10-. Scott SM, Takara T, Varkey B, et al: Thoracic mycotic and actinomycotic infections in General Thoracic Surgery: Ed: W.Shields; Williams and Wilkins, Baltimore,1994;986.
  • 11- British Thoracic and Tuberculosis Association: Aspergilloma and residual tuberculous cavities: the results of re-survey. Tubercle 1970;51:227– 45.
  • 12- Odev K. Toraks Radyolojisi kitabı, Genisletilmis¸ ikinci baskı. Nobel Tıp Kitapevleri. 2010;;214-215
  • 13- Jewkes J, Kay PH, Paneth M, Citron KM. Pulmonary aspergilloma: analysis of prognosis in relation to haemoptysis and survey of treatment. Thorax 1983;38:572– 8.
  • 14- el Oakley R, Petrou M, Goldstraw P. Indications and outcome of surgery for pulmonary aspergilloma. Thorax 1997; 52:813–5.
  • 15- Herbrecht R, Denning DW, Patterson TF et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis N Engl J Med 2002;347(6):408-15.
  • 16- Babatasi G, Massetti M, Chapelier A, et al. Surgical treatment of pulmonary aspergilloma: current outcome. J Thorac Cardiovasc Surg 2000; 906-12.
  • 17- Regnard JF, Icard P, Nicolasi M, et al. Aspergilloma: a series of 89 surgical cases. Ann Thorac Surg 2000; 69:898-903.
  • 18- Daly RC, Pairolero PC, Piehler JM, et al. Pulmonary aspergilloma: results of treatment . J Thorac Cardiovasc Surg 1986; 92: 981-8
  • 19- Battaglini JW, Murray GF, Kaegy BA, et al. Surgical management of symptomatic pulmonary aspergilloma. Ann Thorac Surg 1985;39:512-6
There are 19 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section CASE REPORT
Authors

H.volkan Kara 0000-0001-7702-9731

Ezel Ersen This is me

Mehlika Iscan This is me

İsmail Sarbay

Merve Ekinci This is me

Akif Turna This is me

Publication Date September 26, 2018
Acceptance Date April 27, 2018
Published in Issue Year 2018 Volume: 23 Issue: 3

Cite

Vancouver Kara H, Ersen E, Iscan M, Sarbay İ, Ekinci M, Turna A. Can Long-term Antifungal Therapy Be an Alternative to Surgery in Pulmonary Aspergilloma?. Anatolian Clin. 2018;23(3):189-94.

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