Treatment of Pulmonary Aspergilloma With Amphotericin B

ISOLATED SOLATED therapeutic successes in the treatment of bronchopulmonary aspergillosis have been reported following the administration of nystatin by aerosol¹as well as oral intake of large doses of potassium iodide.²Parenteral injection of stilbamidine³and, more recently, amphotericin B⁴,⁵have also been considered to be successful in isolated cases. However, clinical effectiveness against deep-seated fungous diseases has been accompanied by a variety of disturbing side effects and evidence of toxicity during intravenous infusion of the drug⁶,⁷Fatal reactions due to renal or hepatic failure and drug hypersensitivity have also been recorded in the human.⁸⁻¹⁰Furthermore, systemic drug therapy appears to have particularly limited value in the treatment of freelyingAspergillusfungus ball. There is only one preliminary report¹¹of endobronchial use of amphotericin B in the English literature. In this report, amphotericin B was instilled intrabronchially by tracheal puncture in one patient