[吸入两性霉素B脂质体治疗肺移植受者肺曲霉病1例报告]。

The Japanese journal of antibiotics Pub Date : 2013-02-01
Masaki Fujita, Jun Yanagisawa, Masafumi Hiratsuka, Takeshi Shiraishi, Ryosuke Hirano, Takemasa Matsumoto, Motokimi Shiraishi, Akinori Iwasaki, Kentaro Watanabe
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引用次数: 0

摘要

我们报告一例肺移植受者肺曲霉病成功治疗吸入抗真菌剂。该病例为33岁女性。两年前,她因为淋巴管平滑肌瘤病接受了肺移植手术。一年前,她被诊断为肺曲霉病,并成功地用米卡芬净和伊曲康唑治疗。此后持续给予伊曲康唑治疗。xx年6月出现恶心、呕吐,诊断为病毒性肠炎。虽然腹部症状减轻,但右肺发现磨玻璃样混浊。支气管镜检查显示支气管溃疡伴白色坏死物质。实验室培养结果显示为曲霉属,最后诊断为复发性肺曲霉病。首先,她接受血管内给药米卡芬宁治疗。然后改变两性霉素B脂质体吸入给药方式。肺曲菌病的磨玻璃影及支气管区改善。此后继续吸入两性霉素B,未发现肺曲霉病复发。吸入抗真菌剂可能是肺曲霉病的一种选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A case report of pulmonary aspergillosis in lung transplant recipient successfully treated with inhalation administration of liposomal amphotericin B].

We report a case of pulmonary aspergillosis in lung transplant recipient who was successfully treated with inhalation administration of anti-fungal agent. The case was 33-year-old female. Two years ago, she had received lung transplant because of lymphangioleiomyomatosis. One year ago, she had diagnosed of pulmonary aspergillosis and successfully treated with micafungin and itraconazole. Then she had been continuous administered with itraconazole. In June 20xx, she had nausea and vomiting and was diagnosed of viral enteritis. Although abdominal symptoms were relieved, ground glass opacity was discovered in her right lung. Bronchoscopic examination revealed ulceration of bronchus with white necrotic substance. Laboratory culture test demonstrated Aspergillus spp. Finally she was diagnosed of recurrent pulmonary aspergillosis. First, she was treated with intravascular administration of micafungin. Then, inhalation administration of liposomal amphotericin B was changed. Ground glass opacity and bronchial region of pulmonary aspergillosis was improved. Thereafter, inhalation of amphotericin B was continued and no recurrence of pulmonary aspergillosis has been found. Inhalation of anti-fungal agent could be an option for pulmonary aspergillosis.

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