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Vol. 31. Issue 2.
Pages 83-85 (February 1995)
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Vol. 31. Issue 2.
Pages 83-85 (February 1995)
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Alternativa terapéutica para los aspergilomas pulmonares complicados no quirúrgicos
Therapeutic alternatives for non-operable, complicated pulmonary aspergilloma
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J. Ortiz de Saracho1, E. Pérez-Rodríguez, P. Navío, J. Flores
Servicios de Neumología, Hospital Ramón y Cajal. Madrid
J. Zapatero*, J. Sánchez**
* Servicios de Cirugía Torácica, Hospital Ramón y Cajal. Madrid
** Servicios de Radiodiagnóstico. Hospital Ramón y Cajal. Madrid
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Se presentan 2 casos de aspergiloma pulmonar (AP) complicado por hemoptisis masiva y criterios de inoperabilidad, en los que, tras fracasar la embolización arterial, se realizó un protocolo terapéutico con anfotericina B a través de un catéter intracavitario. A pesar del tamaño de los micetomas la respuesta terapéutica fue excelente con regresión completa del aspergiloma a las 3-4 semanas de tratamiento, negativizándose las precipitinas frente Aspergillus fumigatus y la presencia del hongo en las muestras del aspirado transcatéter. La hemoptisis masiva fue controlada con ácido épsilon-aminocaproico instilado a través del catéter. No hubo complicaciones, el tratamiento fue bien tolerado y no se observaron recidivas en el seguimiento a lo largo de 24 y 18 meses, respectivamente. Este tratamiento local es la mejor alternativa terapéutica para los AP complicados no operables.

Palabras clave:
Aspergiloma pulmonar
Tratamiento percutáneo
Anfotericina B

We present 2 patients with pulmonar) aspergilloma complicated by massive hemoptysis who were not good candidates for surgery and were treated with intracavitary amphotericin B after arterial embolization failed. In spite of the size of the mycetomas, response to treatment was excellent with full regression of the aspergilloma after 3 to 4 weeks; precipitins to Aspergillus fumigatus became negative and the fungus disappeared from transcatheter aspirate samples. Massive hemoptysis was controlled with epsilon-amino-caproic acid instilled by catheter. No complications were observed, the treatment was well tolerated and no recurrence occurred over a follow-up period of 24 and 18 months, respectively. This local treatment is the best therapeutic alternative for patients with pulmonary aspergilloma who are not candidates for surgery.

Key words:
Pulmonary aspergilloma
Percutaneous treatment
Amphotericin B
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Copyright © 1995. Sociedad Española de Neumología y Cirugía Torácica
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