Successful Treatment of Antifungal Combination Therapy with Inhaled Liposomal Amphotericin B and Oral Voriconazole for Intractable Chronic Progressive Pulmonary Aspergillosis

Noboru Hamada; Mitsunori Ishiga; Suzuka Tanaka; Yasuhiro Ooue; Junko Itano; Hisaaki Tanaka; Shota Yuzurio; Takeshi Horiuchi; Toshimitsu Suwaki; Goro Kimura; Yasushi Tanimoto

doi:10.2169/internalmedicine.6305-20

CASE REPORTS

Successful Treatment of Antifungal Combination Therapy with Inhaled Liposomal Amphotericin B and Oral Voriconazole for Intractable Chronic Progressive Pulmonary Aspergillosis

Noboru Hamada, Mitsunori Ishiga, Suzuka Tanaka, Yasuhiro Ooue, Junko Itano, Hisaaki Tanaka, Shota Yuzurio, Takeshi Horiuchi, Toshimitsu Suwaki, Goro Kimura, Yasushi Tanimoto

Author information

Noboru Hamada
Department of Respiratory Medicine, Okayama City Hospital, Japan
Mitsunori Ishiga
Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, Japan
Suzuka Tanaka
Department of Respiratory Medicine, Okayama City Hospital, Japan
Yasuhiro Ooue
Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, Japan
Junko Itano
Department of Allergy and Respiratory Medicine, Okayama University Hospital, Japan
Hisaaki Tanaka
Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, Japan
Shota Yuzurio
Department of Respiratory Medicine, Okayama City Hospital, Japan
Takeshi Horiuchi
Department of Respiratory Medicine, Okayama City Hospital, Japan
Toshimitsu Suwaki
Department of Respiratory Medicine, Okayama City Hospital, Japan
Goro Kimura
Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, Japan
Yasushi Tanimoto
Department of Allergy and Respiratory Medicine, National Hospital Organization, Minami Okayama Medical Center, Japan

Keywords: chronic progressive pulmonary aspergillosis, fungus ball, inhaled liposomal amphotericin B, antifungal combination therapy, Aspergillus niger

JOURNAL OPEN ACCESS

2021 Volume 60 Issue 15 Pages 2465-2468

DOI https://doi.org/10.2169/internalmedicine.6305-20

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Abstract

We experienced a case of the successful treatment of intractable pulmonary aspergillosis with inhaled liposomal amphotericin B (L-AMB) and oral voriconazole (VRCZ). A 52-year-old man was admitted to our hospital with a fever. Chest computed tomography (CT) revealed an infiltrative shadow. Two separate sputum cultures detected Aspergillus niger. Although we treated the patient with single and combined antifungal agents, the infiltrative shadow worsened. After obtaining sufficient informed consent from the patient, we switched him to an inhaled L-AMB. The infiltrative shadow subsequently improved. The patient has remained well for one year without exacerbation. We herein report the usefulness of inhaled L-AMB and oral VRCZ.

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