Endobronchial cryotherapy for a mycetoma

J Bronchology Interv Pulmonol. 2013 Oct;20(4):330-2. doi: 10.1097/LBR.0000000000000003.

Abstract

Mycetoma is defined as a fungus ball that fills a preexisting lung cavity, most frequently being of tuberculous or sarcoid etiology. The most frequently isolated fungus is the species of Aspergillus, but other fungi such as Fusarium or Zygomycetes can also be present. Most patients lack symptoms. However, presentation may also be with hemoptysis, which can be massive and life-threatening. We describe the case of a 50-year-old man with a history of prior pulmonary tuberculosis, with recurrent episodes of cough and hemoptysis. He was diagnosed to have mycetoma in the left upper lobe cavity. The mycetoma was extracted through bronchoscopy under general anesthesia using a cryoprobe. Treatment was completed with amphotericin B instilled in the cavity and the patient was placed on oral itraconazole. This is the first case report to date in which cryotherapy was used to remove a mycetoma.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use
  • Bronchoscopy / methods*
  • Cough / diagnostic imaging
  • Cough / therapy
  • Cryotherapy / methods*
  • Fusariosis / diagnostic imaging
  • Fusariosis / physiopathology
  • Fusariosis / therapy*
  • Hemoptysis / diagnostic imaging
  • Hemoptysis / etiology
  • Hemoptysis / therapy
  • Humans
  • Instillation, Drug
  • Lung Diseases, Fungal / diagnostic imaging
  • Lung Diseases, Fungal / physiopathology
  • Lung Diseases, Fungal / therapy*
  • Male
  • Middle Aged
  • Mycetoma / diagnostic imaging
  • Mycetoma / physiopathology
  • Mycetoma / therapy*
  • Radiography
  • Recurrence
  • Tuberculosis, Pulmonary / complications

Substances

  • Antifungal Agents
  • Amphotericin B