Pulmonary Procedures |

Intracavitary Pulmonary Aspergilloma Removal Using Combined Virtual, Ultrathin, and Rigid Bronchoscopy - A Case Series FREE TO VIEW

David Stather, MD; Alain Tremblay, MD; Paul MacEachern, MD; Alex Chee, MD; Jacob Gelberg, MD; Elaine Dumoulin, MD; Gary Gelfand, MD; Michael Parkins, MD; Christopher Mody, MD
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University of Calgary, Calgary, AB, Canada

Chest. 2013;144(4_MeetingAbstracts):817A. doi:10.1378/chest.1666716
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SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 29, 2013 at 04:30 PM - 05:30 PM

PURPOSE: Intracavitary pulmonary aspergilloma is a chronic debilitating fungal infection associated with significant mortality. Without definitive therapy, death from aspergilloma can occur from massive hemoptysis, cachexia or secondary infection. While surgical resection has been the accepted treatment of choice, it is associated with significant morbidity and mortality and is not a therapeutic option for many patients because of poor pulmonary function or debility. Bronchoscopic removal in combination with antifungal therapy provides an important alternative therapy for this life threatening disease.

METHODS: We describe a series of 5 cases of bronchoscopic removal of intracavitary aspergilloma with a technique involving virtual bronchoscopy to guide the procedure, ultrathin bronchoscopy, rigid bronchoscopy, combined with antifungal therapy.

RESULTS: Successful removal of the aspergilloma with symptom improvement or resolution was achieved in all five cases. Minor post procedure hypoxia was observed in 3 cases. Severe sepsis requiring an extended critical care unit stay was seen in one case. Follow up ranged from 12 to 46 months.

CONCLUSIONS: This is the first reported case series of bronchoscopic removal of intracavitary pulmonary aspergilloma.

CLINICAL IMPLICATIONS: Although not without associated complications of minor hypoxia and possible sepsis, in carefully selected patients this new treatment modality provides an important alternative therapy for this life threatening disease.

DISCLOSURE: The following authors have nothing to disclose: David Stather, Alain Tremblay, Paul MacEachern, Alex Chee, Jacob Gelberg, Elaine Dumoulin, Gary Gelfand, Michael Parkins, Christopher Mody

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