amphotericin-b and Vascular-Fistula

Gastrointestinal mucormycosis is a rare, often fatal, systemic infection found predominantly in immunocompromised patients. We report a case of gastrointestinal mucormycosis in a 53-year-old female with non-Hodgkin's lymphoma. Following her first course of chemotherapy, bowel obstruction developed as a result of mucormycosis. Despite treatment with antifungal therapy, she required a laparotomy owing to severe haemorrhage caused by mucormycosal invasion of her iliac artery. With continued antifungal treatment and further chemotherapy, she ultimately underwent reversal of her Hartmann's procedure and remains disease-free.

Topics: Amphotericin B; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Disease-Free Survival; Doxorubicin; Female; Gastrointestinal Diseases; Granulocyte-Macrophage Colony-Stimulating Factor; Hemorrhage; Humans; Iliac Artery; Immunocompromised Host; Intestinal Fistula; Lymphoma, Non-Hodgkin; Middle Aged; Mucormycosis; Prednisolone; Vascular Fistula; Vincristine

Ulcerative tracheobronchial aspergillosis after lung transplantation (ltx) may lead to bronchial-pulmonary artery fistula that results in fatal bleeding. We report our early experience with combined systemic, aerolized and topical application of amphotericin B in 3 cases of bronchial aspergillosis after ltx. Two patients are still alive, but 1 died of bleeding from a fistula between the left upper lobe bronchus and the pulmonary artery. Aspergillosis in the second patient resolved with minimal stenosis of the left main and the left upper lobe bronchus, and the third patient developed an anastomotic stenosis that was successfully dilated.

Topics: Administration, Inhalation; Administration, Topical; Adult; Aerosols; Amphotericin B; Anastomosis, Surgical; Antifungal Agents; Aspergillosis; Bronchi; Bronchial Diseases; Bronchial Fistula; Constriction, Pathologic; Fatal Outcome; Female; Hemorrhage; Humans; Lung Diseases, Fungal; Lung Transplantation; Male; Middle Aged; Pulmonary Artery; Vascular Fistula