Monaldi cavernostomy for lung aspergillosis: A case report.

cavernostomy mycetoma pulmonary aspergillosis pulmonary suppuration respiratory failure

Journal

Experimental and therapeutic medicine
ISSN: 1792-1015
Titre abrégé: Exp Ther Med
Pays: Greece
ID NLM: 101531947

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 22 01 2021
accepted: 22 02 2021
entrez: 2 8 2021
pubmed: 3 8 2021
medline: 3 8 2021
Statut: ppublish

Résumé

Pulmonary aspergillosis in patients with respiratory failure can severely affect the pulmonary functional status and may aggravate it through pulmonary suppuration, by recruitment of new parenchyma and hemoptysis, which can sometimes be massive, with lethal risk by flooding the bronchus. The treatment consists of a combination of medical therapy, surgery and interventional radiology. In small lesions, less than 2-3 cm, medical therapy methods may be sufficient; however, in invasive forms (larger than 3 cm) surgical resection is necessary. Surgical resection is the ideal treatment; nevertheless, when lung function does not allow it, action must be taken to eliminate the favorable conditions of the infection. In such cases, whenever the lung cavity is peripheral, a cavernostomy may be performed. Four cases of lung cavernous lesions colonized with aspergillus, in which the need for a therapeutic gesture was imposed by repeated small to medium hemoptysis and by the progression of respiratory failure, were evaluated, one of which is presented in the current study. Cavernostomy closure can be realized either surgically with muscle flap or spontaneously by scarring, after closure of the bronchial fistulas by epithelization and granulation. There were no recurrences of hemoptysis or suppurative phenomena. There was one death, a patient with severe respiratory failure caused by superinfection with nonspecific germs. However, in the case presented in this study, the patient recovered following cavernostomy, which seems to be an effective and safe method for cases in which lung resection is not feasible.

Identifiants

pubmed: 34335899
doi: 10.3892/etm.2021.10389
pii: ETM-0-0-10389
pmc: PMC8290423
doi:

Types de publication

Journal Article

Langues

eng

Pagination

957

Informations de copyright

Copyright: © Petreanu et al.

Déclaration de conflit d'intérêts

The authors declare that they have no competing interests.

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Auteurs

Cornel Petreanu (C)

Department of Thoracic Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Thoracic Surgery, 'Marius Nasta' National Institute of Pneumology, 050159 Bucharest, Romania.

Alina Croitoru (A)

Department of Thoracic Surgery, 'Marius Nasta' National Institute of Pneumology, 050159 Bucharest, Romania.
Department of Pneumology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Alexandru Gibu (A)

Department of Thoracic Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Alexandru Zariosu (A)

Department of Thoracic Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Nicolae Bacalbasa (N)

Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Visceral Surgery, Center of Excellence in Translational Medicine, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania.
Department of Obstetrics and Gynecology, 'I. Cantacuzino' Clinical Hospital, 030167 Bucharest, Romania.

Irina Balescu (I)

Department of Visceral Surgery, 'Ponderas' Academic Hospital, 021188 Bucharest, Romania.

Camelia Diaconu (C)

Department of Internal Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania.

Ovidiu Stiru (O)

Department of Cardiovascular Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Cardiovascular Surgery, 'Prof. Dr. C. C. Iliescu' Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania.

Mihai Dimitriu (M)

Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Obstetrics and Gynecology, 'Sf. Pantelimon' Emergency Clinical Hospital, 021659 Bucharest, Romania.

Dragos Cretoiu (D)

Department of Cell and Molecular Biology and Histology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Cornel Savu (C)

Department of Thoracic Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Thoracic Surgery, 'Marius Nasta' National Institute of Pneumology, 050159 Bucharest, Romania.

Classifications MeSH