Clinical utility of intrabronchial antifungal instillation in a complicated case of chronic pulmonary aspergillosis : case report and systematic review of literature

Chronic pulmonary aspergillosis (CPA) is a progressive, debilitating clinical condition associated with significant morbidity. Surgery is the mainstay of treatment for life-threatening hemoptysis in symptomatic patients with simple aspergillomas. However, in patients with chronic cavitary pulmonary aspergillosis, surgical removal of aspergillomas is fraught with difficulty due to debilitating nature of the illness. Here we present a case showcasing the utility of intrabronchial voriconazole instillation in controlling hemoptysis in a patient unfit for surgery followed by systematic review of literature involving 11 clinical studies after screening a total of 5572 studies from PubMed and Google Scholar database. Data gathered from these studies addresses the concerns regarding the efficacy, safety of the procedure as well as draws attention regarding several lacunae in our existing knowledge. A 53-year-old male with chronic pulmonary aspergillosis who had recurrent episodes of hemoptysis despite bronchial artery embolization and was unfit for surgery due to limited lung reserve, patient underwent single session of intrabronchial voriconazole instillation which resulted in dramatic symptomatic and radiological improvement. Intrabronchial antifungal instillation may be a safe and effective option for hemoptysis control in patients with chronic pulmonary aspergillosis.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:31

Enthalten in:

Le infezioni in medicina - 31(2023), 4 vom: 04., Seite 575-582

Sprache:

Englisch

Beteiligte Personen:

Sharma, Sreyas [VerfasserIn]
Kumar, Rohit [VerfasserIn]
Ish, Pranav [VerfasserIn]
Mahendran, A J [VerfasserIn]
Gupta, Neeraj Kumar [VerfasserIn]
Gupta, Nitesh [VerfasserIn]
Madan, Manu [VerfasserIn]

Links:

Volltext

Themen:

Antifungals
Bronchial artery embolization
Case Reports
Chronic cavitary pulmonary aspergillosis
Chronic pulmonary aspergillosis

Anmerkungen:

Date Revised 11.12.2023

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.53854/liim-3104-17

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM365662259