Related Experiment Videos

Management of postpneumonectomy Aspergillus empyema extending into the thoracic wall: a plea for radical surgery and

N Lampo1, A Spiliopoulos, M Licker

  • 1Centre Valaisan de Pneumologie, 3962 Montana, Switzerland.

Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
PubMed

Insights

This case report details a rare semi-invasive aspergillosis infection. Successful treatment involved surgery and itraconazole after antifungal therapy failed.

Area of Science:

  • Medical Mycology
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Semi-invasive aspergillosis is a rare but severe fungal infection.
  • Its management, particularly in immunocompetent patients, is not well-established.
  • Aspergillus empyema can lead to significant thoracic complications.

Purpose of the Study:

  • To report a case of invasive Aspergillus empyema following pneumonectomy.
  • To discuss the therapeutic challenges and outcomes of antifungal and surgical interventions.
  • To highlight a successful treatment strategy for a complex thoracic fungal infection.

Main Methods:

  • Case presentation of a 54-year-old female with Aspergillus empyema.
  • Initial treatment with systemic and intrapleural amphotericin B.
  • Subsequent surgical intervention: open-window thoracotomy with latissimus dorsi flap.
  • Treatment with oral itraconazole.

Main Results:

  • Initial antifungal therapy was unsuccessful and led to an anaphylactic reaction.
  • Surgical management with muscle flap transposition was performed.
  • The patient received itraconazole and showed no signs of recurrent infection at 3-year follow-up.
  • The thoracostomy was successfully closed after 6 months.

Conclusions:

  • Aggressive surgical management may be crucial for refractory Aspergillus empyema.
  • Itraconazole can be an effective salvage therapy in cases of antifungal intolerance.
  • This case demonstrates a successful multidisciplinary approach to a rare, invasive fungal infection.

Related Concept Videos

Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Endoscopic Studies I: Bronchoscopy and Thoracoscopy01:30

Endoscopic Studies I: Bronchoscopy and Thoracoscopy

Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due to...
Pneumonia IV: Management01:28

Pneumonia IV: Management

The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Pneumonia V: Nursing management and Prevention01:30

Pneumonia V: Nursing management and Prevention

Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Pleural Effusion II: Symptoms and Management01:28

Pleural Effusion II: Symptoms and Management

Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations: