1/8. Allergic bronchopulmonary aspergillosis due to aspergillus niger without bronchial asthma.A 65-year-old woman was admitted to our hospital with a dry cough and pulmonary infiltrates. Chest radiograph and CT revealed mucoid impaction and consolidations. Peripheral blood eosinophilia and elevated serum IgE were observed. aspergillus niger was cultured repeatedly from her sputum, but A. fumigatus was not detected. Immediate skin test and specific IgE (RAST) to Aspergillus antigen were positive. Precipitating antibodies were confirmed against A. niger antigen, but not against A. fumigatus antigen. She had no asthmatic symptoms, and showed no bronchial hyperreactivity to methacholine. Thus, this case was diagnosed as allergic bronchopulmonary aspergillosis (ABPA) without bronchial asthma due to A. niger, an organism rarely found in ABPA. The administration of prednisone improved the symptoms and corrected the abnormal laboratory findings.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/8. rhabdomyolysis after the administration of itraconazole to an asthmatic patient with bronchopulmonary aspergillosis.It is known that the coadministration of itraconazole with cholesterol-lowering statins may induce muscle damage. We describe the case of a patient with steroid-dependent asthma, steroid-induced severe myopathy and allergic bronchopulmonary aspergillosis who developed rhabdomyolysis and acute renal failure following a approximately 6-week treatment with itraconazole, even without the concomitant use of HMG-CoA reductase inhibitors.- - - - - - - - - - ranking = 5keywords = administration (Clic here for more details about this article) |
3/8. Disseminated mucormycosis associated with invasive pulmonary aspergillosis in a patient treated for post-transplant high-grade non-Hodgkin's lymphoma.The incidence of mucormycosis, defined as systemic infection caused by fungi of the class Phycomycetes has been increasing over the past 2 decades, especially in profoundly immunocompromised hosts. We report a new case in a patient presenting with post-transplant high-grade non-Hodgkin's lymphoma who received a prolonged treatment with voriconazole and caspofungin for an invasive pulmonary aspergillosis. Definite diagnosis of mucormycosis was made by liver biopsy of nodules mimicking progressive lymphoma. The patient died 1 week after the diagnosis of mucormycosis despite the administration of liposomal amphotericin b. The role of voriconazole and caspofungin in the emergence of mucormycosis is discussed.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
4/8. Inhaled budesonide induced Cushing's syndrome in cystic fibrosis patients, due to drug inhibition of cytochrome P450.Two CF patients developed Cushing's syndrome during administration of inhaled budesonide (400 microg/d) with oral itraconazole in one and with clarithromycin in the other patient. Clinical features appeared respectively after 2 and 6 weeks of drug co-administration, with prolonged adrenal suppression, and a slow recovery after ceasing the drugs. Inhibitors of the cytochrome P450 interfere with the metabolism of corticosteroids. Combination of these drugs even with moderate doses of budesonide should be closely monitored.- - - - - - - - - - ranking = 2keywords = administration (Clic here for more details about this article) |
5/8. Pulmonary aspergillosis with possible cerebral involvement in a previously healthy pregnant woman.Invasive aspergillosis is observed mainly in immunodepressed patients. Here we report a case of pulmonary aspergillosis with CNS involvement in a pregnant woman without other known causes of immunodeficiency. Case report: A 23-years old pregnant woman underwent a caesarean because of unexplained seizures. During the subsequent days worsening headache and a deteriorating neurological status were reported suggesting meningitis. Stiffness, right sided hemiparesis and cranial nerve palsies were observed at admission. Radiological findings revealed lesions involving the right pulmonary apex, the right cerebellar hemisphere and the Pterygopalatina fossa. Microbiological studies revealed large colonies of aspergillus fumigatus. A favorable outcome was observed after administration of liposomal amphotericin b and 5-fluorocytosine and, at improved conditions, when oral uptake of itraconazole was given. The authors conclude that risk of infections sustained by fungal opportunistic agents during pregnancy must be considered. Sequential antifungal administration may be an efficient therapy able to shorten hospitalization.- - - - - - - - - - ranking = 2keywords = administration (Clic here for more details about this article) |
6/8. Treatment of symptomatic pulmonary aspergillomas with intracavitary instillation of amphotericin b through an indwelling catheter.BACKGROUND--The treatment of symptomatic pulmonary aspergillomas can be difficult. One approach has been to deliver antifungal drugs directly into the lung cavity. The use of this method of treatment is described in which an indwelling percutaneous catheter is used which avoids repeated needlings of the cavity and may allow extended treatment on a domiciliary basis. methods--amphotericin b was delivered through indwelling percutaneous intracavitary catheters to treat five symptomatic episodes in four patients with pulmonary aspergillomas. RESULTS--The treatment was well tolerated by all patients and their symptoms resolved in four of the five episodes. Two patients died, one from an unrelated bronchopneumonia and the other from advanced cachexia. Two patients remain symptom free after eight and 12 months. CONCLUSIONS--Intracavitary administration of amphotericin through an indwelling catheter should be considered for any patient who has troublesome sputum production, haemoptysis, or systemic symptoms attributable to an aspergilloma.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
7/8. Usefulness of inhaled high-dose corticosteroids in allergic bronchopulmonary aspergillosis.Two patients with allergic bronchopulmonary aspergillosis were seen on a regular basis, one since 1978 and the other since 1982. Throughout this period, both subjects required daily oral administration of corticosteroids (between 15 and 40 mg of prednisolone daily) to control their symptoms and the lung infiltrates on the chest x-ray film. Attempts to further decrease the dosage of steroids or to discontinue their use were met with immediate recurrences of manifestations of the disease. With the introduction of high-dose inhaled beclomethasone dipropionate, both subjects could be weaned from their oral steroids and maintained with inhaled steroids alone for up to 11 months. We conclude that inhaled corticosteroids may be useful in the treatment of allergic bronchopulmonary aspergillosis.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
8/8. invasive pulmonary aspergillosis complicated by subclavian artery occlusion following allogeneic stem cell transplantation.We describe an unusual case of invasive pulmonary aspergillosis (IPA) complicated by subclavian artery occlusion in a 32-year-old man with severe aplastic anemia, who underwent allogeneic stem cell transplantation. He was severely neutropenic after the conditioning for transplantation, but he had no history of fungal infection. Five days after the transplantation, he developed IPA in the left upper lung, complicated by left subclavian artery occlusion. Extensive chronic graft-versus-host disease, which required the administration of potent immunosuppressants for a long period of time, interfered with the resolution of the IPA.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |