1996 Volume 18 Issue 6 Pages 584-589
The treatment of pulmonary aspergilloma is divided into surgical resection and medical treatment. Surgical resection is the first choice in point of effectiveness, but is often impossible because of severe, underlying pulmonary impairment. We infused amphotericin B selectively into a cavity with a balloon catheter using a flexible bronchofiberscope in two patients with symptomatic pulmonary aspergillomas. In one patient, a bronchofiberscopy was performed 9 times and 180mg in total of amphotericin B was infused and the aspergilloma disappeared after treatment. In another patient, a bronchofiberscopy was performed 10 times and 200mg in total of amphotericin B was infused. The aspergilloma decreased in size remarkably and serologic study of Aspergillus spp. precipitins was negative after treatment. The fever was seen on the day of infusion in the both patients, but there was no other side-effect and it was tolerable. Transbronchial intracavitary infusion therapy with balloon catheter is a safe and easy method, and should be considered in patients with symptomatic pulmonary aspergilloma, particularly when surgical resection is not feasible.
