Which of the following drug was most likely given IV to this patient?
A 32-year-old man suffering from a non-Hodgkin’s lymphoma presented with fever,
a cough, increasing dyspnea and hemoptysis. The man was in the hospital for the second
the cycle of chemotherapy. Chest radiograph disclosed diffuse alveolar infiltrates on the right
lobe and multiple small cavitary lesions on the left lobe. A bronchoalveolar lavage
revealed fungal forms typical of Aspergillus genus.
A. Flucytosine B. Terbinafine C. Griseofulvin D. Amphotericin B E. Nystatin
Amphotericin b-answer: d
fungi of the genus aspergillus usually coexist with man in harmless symbiosis. in special
circumstances, however, some species may play an opportunistic role in producing disease in
humans. patients with chemotherapy-induced neutropenia or impaired immune responses by
any cause are at high risk for invasive pulmonary aspergillosis, like in the present case. recent
studies indicate that the isolation of aspergillus in bronchoalveolar lavage fluid correlates
strongly with histologic evidence of parenchymal invasion. the disease is treated with
amphotericin b, but most patient die within few weeks of the diagnosis.
a) flucytosine is effective in vitro against aspergillus species, but is not used clinically alone
and even the addition to amphotericin b does not seem to add significant benefit.
b, c) these antifungal drugs are not effective against aspergillus species.
e) nystatin is too toxic for parenteral administration and is only used topically.