Endobronchial cryotherapy for a mycetoma.

Area of Science:

• Pulmonology
• Infectious Diseases
• Medical Mycology

Background:

• Pulmonary mycetoma, often a complication of pre-existing lung cavities (e.g., tuberculosis, sarcoidosis), is typically caused by Aspergillus species.
• While often asymptomatic, mycetoma can lead to severe, life-threatening hemoptysis.
• Current treatment options may be limited, necessitating innovative approaches.

Observation:

• A 50-year-old male with a history of pulmonary tuberculosis presented with recurrent cough and hemoptysis.
• He was diagnosed with a left upper lobe mycetoma.
• The mycetoma was successfully removed using bronchoscopic cryoprobe extraction under general anesthesia.

Findings:

• Cryotherapy, utilizing a cryoprobe, proved effective for the minimally invasive removal of pulmonary mycetoma.
• Post-extraction treatment included intra-cavitary amphotericin B and oral itraconazole.
• This represents the first documented use of cryotherapy for mycetoma extraction.

Implications:

• Cryotherapy offers a promising, less invasive alternative for pulmonary mycetoma management.
• This technique may reduce the need for more extensive surgical interventions.
• Further research into cryotherapy's efficacy and safety in mycetoma treatment is warranted.