Can Long-term Antifungal Therapy Be an Alternative to Surgery in Pulmonary Aspergilloma?
Öz
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
Anahtar Kelimeler
Kaynakça
- 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.