| Intrabronchial instillation of amphotericin B lipid complex: a case report. | |
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MedLine Citation:
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PMID: 19715880 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We sought to present our results of topical intrabronchial installation of amphotericin B lipid complex (AmpB lipid). PATIENT AND METHODS: A deposit of fungal material was observed in a bilateral lung transplant recipient who experienced stenosis of the left anastomosis and have been fitted with a double endobronchial prosthesis. The deposit was adherent to the prosthetic material, causing marked local laceration, risk of perforation, and exacerbation of the bronchial stenosis. Upon cultivation of a bronchial aspirate (BAS), we isolated Aspergillus fumigatus, Scedosporium prolificans, and Candida glabrata. Systemic antifungal treatment was begun with oral voriconazole (200 mg every 12 hours) and inhaled AmpB lipid (25 mg once daily). The fungal deposit on the prosthetic material was treated by topical instillation of a solution of 25 mg AmpB lipid before and after each therapeutic fibrobronchoscopy (FB), which was performed weekly at 5 consecutive examinations. Tolerance was excellent. RESULTS: The improvement obtained after the procedure made it possible to withdraw one of the displaced prostheses. Subsequent cultivation for the fungi found in the BAS was persistently negative over a follow-up of 2 years. CONCLUSION: Topical intrabronchial instillation of AmpB lipid has proven effective and well tolerated for the treatment of localized fungal colonies. This use could be extended by protocol to FB in the early postoperative period after lung transplantation for antifungal prophylaxis. |
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Authors:
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P Morales; G Gal??n; E Sanmart??n; E Monte; V Tarrazona; M Santos |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Transplantation proceedings Volume: 41 ISSN: 1873-2623 ISO Abbreviation: Transplant. Proc. Publication Date: 2009 Jul-Aug |
Date Detail:
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Created Date: 2009-08-31 Completed Date: 2010-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0243532 Medline TA: Transplant Proc Country: United States |
Other Details:
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Languages: eng Pagination: 2223-4 Citation Subset: IM |
Affiliation:
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U Trasplante Pulmonar, Hospital Cl??nico, Valencia, Spain. pila1460@separ.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amphotericin B / administration & dosage, therapeutic use* Antifungal Agents / administration & dosage, therapeutic use Aspergillosis / drug therapy Aspergillus fumigatus / drug effects, isolation & purification Bronchi Candida glabrata / drug effects, isolation & purification Candidiasis / drug therapy Cystic Fibrosis / surgery Follow-Up Studies Humans Instillation, Drug Lung Transplantation / adverse effects* Male Mycetoma / drug therapy Postoperative Complications / drug therapy, microbiology Scedosporium / drug effects, isolation & purification |
| Chemical | |
Reg. No./Substance:
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0/Antifungal Agents; 0/liposomal amphotericin B; 1397-89-3/Amphotericin B |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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