One Patient’s Success Story

[Guest guest]

One Patient's Success Story - 18 years on antifungal treatment and still going

strong!

Article from December Aspergillus Newsletter - aspergillus.org.uk

This month we highlight the story of a special patient who was diagnosed with

chronic pulmonary aspergillosis (CPA) back in 1991 and after 18 years on and off

various treatments, he has been stable on itraconazole for 13 years.

It all started back in 1991 when a health check revealed a suspicious lung

lesion. This was treated with surgery and a lung resection and he seemed to be

cured. The patient did not have any signs of a poor immune system. Microscopic

examination of the removed lung showed the presence of fungal hyphae.

A year later the patient came back to hospital because he was coughing up blood.

A scan showed a new large cavity near the area of previous surgery. A

bronchoscopy sample grew aspergillus and blood tests were positive for

aspergillus antibodies. The diagnosis of CPA was made. Initial treatments with

antifungals gave considerable improvement. In 1993 this patient was one of the

first to trial oral voriconazole and his experience contributed to approval of

this antifungal in 2002.. Voriconazole improved his condition but he was

unfortunate to develop a red photosensitive rash on his face and after 6 months

it was discontinued. He tried IV amphotericin which also was successful in the

short term.

The mainstay of this patient's treatment has been ongoing itraconazole therapy –

essentially it has stabilised his condition over a 13 year period – when

itraconazole was discontinued – his condition worsened, but he regained his

health a few months after itraconazole was re-started. He is currently in

reasonable health – he has an ongoing cough but manages to lead a good

lifestyle.

(We thank Patient RW for agreeing to share his experience with other

aspergillosis patients).