Treatment of Pulmonary Aspergilloma with Amphotericin B

Abstract

ISOLATED SOLATED therapeutic successes in the treatment of bronchopulmonary aspergillosis have been reported following the administration of nystatin by aerosol 1 as well as oral intake of large doses of potassium iodide. 2 Parenteral injection of stilbamidine 3 and, more recently, amphotericin B 4,5 have also been considered to be successful in isolated cases. However, clinical effectiveness against deep-seated fungous diseases has been accompanied by a variety of disturbing side effects and evidence of toxicity during intravenous infusion of the drug 6,7 Fatal reactions due to renal or hepatic failure and drug hypersensitivity have also been recorded in the human. 8-10 Furthermore, systemic drug therapy appears to have particularly limited value in the treatment of freelying Aspergillus fungus ball. There is only one preliminary report 11 of endobronchial use of amphotericin B in the English literature. In this report, amphotericin B was instilled intrabronchially by tracheal puncture in one patient