Use of Video-Assisted Thoracoscopy Surgery for the Treatment of Aspergillus Empyema with Bronchopleural Fistula

Introduction

Pulmonary aspergillosis is generally regarded as an opportunistic infection, as it usually results from a pathologically reduced state of immunity, the use of immunosuppressive drugs, or flora disturbance caused by long-term antibiotic therapy. Severe invasive pulmonary aspergillosis predisposes to the formation of lung abscesses and empyemas which may further lead to the development of a bronchopleural fistula. Antifungal therapy is usually inefficient at this stage of the disease as demonstrated by the rare case reports that have discussed the medical treatment of this condition [1], [2]. In our case, video-assisted thoracoscopy surgery was used to treat a patient with an aspergillus empyema and a bronchopleural fistula, with successful resolution 3 months postoperatively.

References

• 1 Soto-Hurtado E J, Marin-Gamez E, Segura-Dominguez N. et al . Pleural aspergillosis with bronchopleurocutaneous fistula and costal bone destruction: a case report.  Lung. 2005;  183 417-423
• 2 Mukae H, Iwamoto M, Tagawa H. et al . A case of aspergillus empyema with bronchopleural fistula.  Nihon Kyobu Shikkan Gakkai Zasshi. 1990;  28 1482-1487
• 3 Shirakusa T, Ueda H, Takata S. et al . Use of pedicled omental flap in treatment of empyema.  Ann Thorac Surg. 1990;  50 420-424
• 4 Wex P, Utta E, Drozdz W. Surgical treatment of pulmonary and pleuro-pulmonary aspergillus disease.  Thorac Cardiovasc Surg. 1993;  41 64-70