Date: 7 February 2014
Image B
Copyright:
Dr D Denning, Wythenshawe Hospital, Manchester.(© Fungal Infection Trust)
Notes:
Patient BC
A petite women in her 50’s with severe asthma and fungal sensitization (SAFS) had been unable to tolerate either itraconazole or voriconazole for any length of time, and was severely disabled with her symptoms. One treatment option which is occasionally helpful is to give nebulised amphotericin B (link to video of Helen). She was given 10mg of amphotericin B deoxycholate in water through a Pari LC nebulizer, supervised by a senior physiotherapist. Shortly after starting this, she felt much more breathless and the nebulizer was stopped. Salbutamol rescue was administered. After about 40 minutes she recovered.
The spirometer readings show a starting FEV1 of 2.35 L/sec. This fell to 1.05 L/sec, a dramatic fall with amphotericin B nebulisation. (Image A) She recovered with salbutamol to 2.25 L/sec. (Image B)
Images library
Showing 10 posts of 2574 posts found.
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Title
Legend
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Image G. 14/5/99
Showing progression of the cavity with some debris inside
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Image F. 14/5/99
Compare with B, showing progressive enlargement of cavity and formation of fungal ball.
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Image E 14/5/99
Showing enlargement of cavity at left apex and formation of a new cavity there.
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Image C. 30/3/99
Parenchymal or pleural disease adjacent to the mediasternum on the left with diffuse parenchymal disease. Also pleural based nodules bilaterally.
