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 aerosol¹ 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