Intracavitary voriconazole for the treatment of hemoptysis complicating Pseudallescheria angusta pulmonary mycetomas in fibrocystic sarcoidosis

Abstract

Pulmonary mycetomas often occur in fibrocystic sarcoidosis. When this condition is complicated by hemoptysis, definitive surgery is usually precluded because of poor lung function. Intracavitary antifungal therapy has been described for the treatment of symptomatic pulmonary mycetomas. We report the first use of intracavitary voriconazole in the management of a Pseudallescheria angusta pulmonary mycetoma complicated by hemoptysis in a patient with fibrocystic sarcoidosis and renal transplant.

Keywords:

• sarcoidosis
• Pseudallescheria angusta
• voriconazole
• mycetoma
• immunosuppression

Acknowledgements

We thank Dr Brian Wickes of the University of Texas Health Science Center at San Antonio for sequencing the TUB region of the beta-tubulin gene in the molecular identification of P. angusta.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This paper was first published online on Early Online on 14 September 2010.