著者: Thomas J Walsh, Elias J Anaissie, David W Denning, Raoul Herbrecht, Dimitrios P Kontoyiannis, Kieren A Marr, Vicki A Morrison, Brahm H Segal, William J Steinbach, David A Stevens, Jo-Anne van Burik, John R Wingard, Thomas F Patterson, Infectious Diseases Society of America
雑誌名: Clin Infect Dis. 2008 Feb 1;46(3):327-60. doi: 10.1086/525258.
Abstract/Text
PMID
18177225 Clin Infect Dis. 2008 Feb 1;46(3):327-60. doi: 10.1086/･･･
著者: B Dupont
雑誌名: J Am Acad Dermatol. 1990 Sep;23(3 Pt 2):607-14.
Abstract/Text
Itraconazole, 200 to 400 mg once daily, was administered to 49 patients with different types of aspergillosis: pulmonary aspergilloma (14 patients), chronic necrotizing pulmonary aspergillosis (14), and invasive aspergillosis (21). Itraconazole was prescribed alone or in combination or after treatment with amphotericin B and flucytosine. Of 14 aspergilloma patients, 2 were cured and 8 had symptomatic improvement. In chronic necrotizing pulmonary aspergillosis, 7 of 14 patients were cured and 6 improved significantly. In invasive aspergillosis treatment failed in 6 patients and 15 were cured. Itraconazole can be an alternative to amphotericin B in the treatment of invasive aspergillosis and chronic necrotizing pulmonary aspergillosis. In aspergilloma itraconazole may be useful in inoperable cases.
PMID
2170481 J Am Acad Dermatol. 1990 Sep;23(3 Pt 2):607-14.
著者: Anne Lejay, Pierre-Emmanuel Falcoz, Nicola Santelmo, Olivier Helms, Evgenia Kochetkova, My Jeung, Romain Kessler, Gilbert Massard
雑誌名: Interact Cardiovasc Thorac Surg. 2011 Oct;13(4):392-5. doi: 10.1510/icvts.2011.265553. Epub 2011 Jul 5.
Abstract/Text
Surgery of aspergilloma has been renowned to be technically challenging and has a high complication rate. We have already demonstrated an improved outcome as a result of a reduction in complex cases related to history of tuberculosis. In this paper we will evaluate whether this time trend has continued during recent years. Initial presentation and postoperative outcome of 33 patients who underwent surgical treatment between 1998 and 2009 were reviewed and compared with two previous reports (group 1: 55 patients from 1974 to 1991; group 2: 12 patients from 1992 to 1997). Underlying disease was tuberculosis in 15% of patients (57% in group 1, 17% in group 2), and 12% of patients had complex aspergillomas (80% in group 1, 41% in group 2). Postoperatively, there was no mortality (5% in group 1, 0% in group 2). Morbidity decreased progressively in terms of bleeding (44% in group 1, 9% in group 2, and 6% in recently, accrued patients), of pleural space problems (47%, 18% and 12%, respectively), and of prolonged hospital stay (32%, 8% and 6%, respectively). With a decreased postoperative complications rate after resection, contemporary surgery of aspergilloma is safe and offers satisfactory early and long-term results.
PMID
21729950 Interact Cardiovasc Thorac Surg. 2011 Oct;13(4):392-5. ･･･
著者: Qian-Kun Chen, Ge-Ning Jiang, Jia-An Ding
雑誌名: Interact Cardiovasc Thorac Surg. 2012 Jul;15(1):77-80. doi: 10.1093/icvts/ivs130. Epub 2012 Apr 11.
Abstract/Text
The surgical treatment of pulmonary aspergilloma is challenging and controversial. This study was designed to evaluate the clinical profile, indications and surgical outcomes of pulmonary aspergilloma operated on in our institute. A total of 256 patients with pulmonary aspergilloma underwent surgical treatment from 1975 to 2010. The patients were divided into two groups: Group A (simple aspergilloma, n = 96) and Group B (complex aspergilloma, n = 160). The principal underlying lung disease was tuberculosis (71.1%). The surgical procedures consisted of 212 lobectomies in both groups; eight cavernoplasties, 10 bilobectomies, 16 pneumonectomies and six thoracoplasties in Group B; four segmentectomies and six wedge resections in Group A. Postoperative complications occurred in 40 patients (15.6%). The major complications were residual pleural space (3.9%), prolonged air leak (3.1%), bronchopleural fistula (1.6%), excessive bleeding (1.6%), respiratory insufficiency (1.9%) and empyema (1.2%). No intraoperative deaths occurred. The overall mortality within 30 days post-operation was 1.2%, occurring only in Group B. There was no statistically significant difference in the postoperative morbidity between Groups A and B (P = 0.27). With the good selection of patients, meticulous surgical techniques and good postoperative management, aggressive surgical treatment with anti-fungal therapy for pulmonary aspergilloma is safe and effective, and can achieve favourable outcomes.
PMID
22499801 Interact Cardiovasc Thorac Surg. 2012 Jul;15(1):77-80. ･･･
著者: J Giron, C Poey, P Fajadet, N Sans, D Fourcade, J P Senac, J J Railhac
雑誌名: Eur J Radiol. 1998 Oct;28(3):235-42.
Abstract/Text
OBJECTIVE: To treat symptomatic pulmonary aspergilloma in patients who were not considered to be operable.
MATERIAL AND METHODS: Forty patients were treated by CT-guided percutaneous injection of amphotericin paste, the aim being to fill the cavity completely and create an anaerobic environment for the aspergillus. The aspergillomas had developed after bacillary infection and pulmonary fibrosis. Surgery was contra-indicated in these patients because of severe respiratory failure. The authors detail the method of preparation of the paste and the technique of percutaneous injection.
RESULTS: Hemoptysis ceased in all 40 patients, with a follow-up ranging from 6 to 28 months; six patients were also treated with bronchial embolization. In 26 patients, the aspergilloma disappeared and serum tests for aspergillus became negative. Complete disappearance of both the aspergilloma and the cavity was obtained in three patients.
CONCLUSION: This technique appears to be a valuable contribution to non-surgical treatment of inoperable patients with pulmonary aspergilloma, but study should be continued in a larger series to define the exact indications and the interaction with other treatments which have recently been introduced.
PMID
9881259 Eur J Radiol. 1998 Oct;28(3):235-42.
