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A Model of Self-limited Acute Lung Injury by Unilateral Intra-bronchial Acid Instillation
Published on: August 30, 2019
Intrabronchial instillation of amphotericin B lipid complex: a case report
P Morales1, G Galán, E Sanmartín
1U Trasplante Pulmonar, Hospital Clínico, Valencia, Spain. pila1460@separ.es
Transplantation Proceedings
|September 1, 2009
Summary
Topical amphotericin B lipid complex (AmpB lipid) effectively treated localized fungal colonies in a lung transplant patient. This method proved well-tolerated and may prevent fungal infections post-transplant.
Area of Science:
- Pulmonology
- Transplant Surgery
- Mycology
Background:
- Lung transplant recipients are susceptible to fungal infections.
- Endobronchial prostheses can harbor fungal growth.
- Fungal infections pose a risk for airway stenosis and graft complications.
Observation:
- A bilateral lung transplant recipient developed a fungal deposit on an endobronchial prosthesis.
- The fungal deposit caused bronchial stenosis, laceration, and perforation risk.
- Isolated fungi included Aspergillus fumigatus, Scedosporium prolificans, and Candida glabrata.
Findings:
- Topical intrabronchial amphotericin B lipid complex (AmpB lipid) was instilled weekly.
- Combined with systemic voriconazole and inhaled AmpB lipid, treatment was well-tolerated.
- Fungal cultures became negative, and one prosthesis was removed due to improvement.
Implications:
- Topical AmpB lipid is effective for localized fungal colonies in airways.
- This treatment warrants consideration for prophylaxis in post-lung transplant patients.
- Further studies could establish protocols for early postoperative antifungal use.
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