Surgery in Primary Pulmonary Coccidioidomycosis and in the Combined Diseases of Coccidioidomycosis and Tuberculosis
1968; Elsevier BV; Volume: 54; Linguagem: Inglês
10.1378/chest.54.supplement_1.278
ISSN2589-3890
AutoresDermont W. Melick, Austin R. Grant,
Tópico(s)Infectious Diseases and Mycology
Resumo1. Surgical treatment of pulmonary coccidioidomycosis may be accompanied by complications in the range of 13 per cent to 26 per cent. The judicious use of amphotericin B as adjunctive therapy should result in a decrease in the complication rate to 5 per cent or below. 2. Lobectomy is the operation of choice. In certain cases, less than lobectomy may be permissible, but failure to use amphotericin B will greatly increase the chances for complications. 3. Careful attention to the exact location of the cavity will allow for a better delineation of surgical technique and obviate complications. It may also preclude the need for amphotericin B in certain situations as specified. 4. To resolve diagnostic confusion and to offer a rational approach to the problem of isolated coccidioidal or tuberculous disease or a combination of the two diseases, a two-month diagnostic "target date" is advocated. Treatment is given depending on the weight of evidence in favor of the presumptive diagnostic impression. If the diagnosis still remains obscure, a "double disease" drug regimen is carried on for an additional 30 days and thoracotomy is then performed.
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