amphotericin-b and Pneumonia--Pneumococcal

The patient was a 61-year-old man. From the end of May 2007 he suffered from pain in the left anterior chest, had fever and consulted our hospital on May 27. On admission chest CT revealed consolidation in the left lung. In venous blood and sputum culture Streptococcus pneumoniae was identified as the causative organism, but despite improvement as a result of treatment, the upper lobe of the left lung showed cavity formation. Inside the cavity, fluid level formation was observed and percutaneous cavernous drainage was performed. Pus culture revealed infection with Aspergillus fumigatus, and we diagnosed chronic necrotizing pulmonary aspergillosis (CNPA). In addition to intravenous antifungal drug administration, 20 mg of amphotericin B (AMPH-B) was administered intracavitary. As symptoms and laboratory findings improved, the patient was discharged on October 12. We reported this case because pneumococcal pneumonia complicated by lung abscess formation is relatively rare, and topical treatment was effective against CNPA.

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Chronic Disease; Humans; Injections, Intralesional; Lung; Lung Abscess; Lung Diseases, Fungal; Male; Middle Aged; Necrosis; Pneumococcal Infections; Pneumonia, Pneumococcal; Treatment Outcome

We describe in detail a 67-yr-old woman who was treated with a cytostatic combination chemotherapy for newly diagnosed common-acute lymphoblastic leukaemia. At the end of induction therapy, the patient acquired invasive mould infection affecting lung and brain. The patient entered complete remission of her leukaemia. Treatment with liposomal amphotericin B was initiated along with surgical excision of the fungal brain abscess. Intrathecal instillation of amphotericin B deoxycholate was started using an Ommaya reservoir because of an anatomical connection between the postoperative cavity and the ventricle. Full dose cytostatic chemotherapy was continued with little delay. A computerised tomography scan of the chest performed 2 months later revealed no fungal abscesses. Magnetic resonance imaging of the brain did not reveal any fungal manifestation. During maintenance therapy/week 69, the patient relapsed from leukaemia. High doses of intravenous liposomal amphotericin B were administered prophylactically. The patient's leukaemia proved refractory to reinduction chemotherapy and the patient died from pneumonia 8 wk later. Post mortem microbiological investigation and histopathological examination of lung and brain tissue did not reveal any macroscopical or microscopical fungal manifestations. This case underlines the feasibility and successful application of combined antileukaemic, antifungal and surgical therapy in a patient with acute leukaemia.

Topics: Aged; Amphotericin B; Antifungal Agents; Antineoplastic Combined Chemotherapy Protocols; Brain Abscess; Combined Modality Therapy; Craniotomy; Deoxycholic Acid; Drug Combinations; Fatal Outcome; Female; Humans; Immunocompromised Host; Infusions, Intravenous; Injections, Spinal; Liposomes; Lung Abscess; Lung Diseases, Fungal; Magnetic Resonance Imaging; Neoplasm Recurrence, Local; Neuroaspergillosis; Pneumonia, Pneumococcal; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Remission Induction; Tomography, X-Ray Computed

Diagnosis and successful therapy for primary cutaneous zygomycosis (mucormycosis) that complicated the securing of an endotracheal tube with cloth tape. Primary cutaneous mucormycosis is a rare fungal infection noted most often in immunosuppressed individuals. Cloth tape, of the type commonly used to secure endotracheal tubes, often is contaminated with fungal spores. In the case reported here, cloth tape securing the endotracheal tube was the probable vector for transmission of zygomycosis to a moderately imunocompromised host. Rapid diagnosis and combined medical and surgical therapy resulted in a favorable outcome.

Topics: Adult; Amphotericin B; Antifungal Agents; Dermatomycoses; Disease Reservoirs; Equipment Contamination; Facial Dermatoses; Female; Follow-Up Studies; Humans; Immunocompromised Host; Intubation, Intratracheal; Lupus Erythematosus, Systemic; Mucormycosis; Pneumonia, Pneumococcal; Rhizopus; Spores

A patient was treated for lobar pneumonia due to coccidioidomycosis. When the pneumonia recurred, the patient was found to have an arteriovenous malformation, which had become infected. Complete resolution was achieved with resection and postoperative amphotericin B therapy.

Topics: Adult; Amphotericin B; Arteriovenous Malformations; Coccidioidomycosis; Female; Humans; Lung; Pneumonia, Pneumococcal; Recurrence

Topics: Amphotericin B; Anti-Bacterial Agents; Antiviral Agents; Bacterial Infections; Drug Therapy, Combination; Humans; Infant, Newborn; Pneumonia; Pneumonia, Pneumococcal; Pneumonia, Staphylococcal; Pneumonia, Viral

Topics: Adult; Aged; Amphotericin B; Aspergillosis; Child; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Pneumonia, Pneumococcal; Pulmonary Embolism; Radiography

Topics: Amphotericin B; Biopsy; Candidiasis; Chlorambucil; Diagnosis, Differential; Hodgkin Disease; Humans; Lung Diseases; Lung Diseases, Fungal; Pneumonia; Pneumonia, Pneumococcal; Prednisone; Radiography, Thoracic; Vancomycin