Topical amphotericin B application in severe bronchial aspergillosis afterlung transplantation: Report of experiences in 3 cases

Ulcerative tracheobronchial aspergillosis after lung transplantation (ltx) may lead to bronchial-pulmonary artery fistula that results in fatal bleedi ng. We report our early experience with combined systemic, aerolized and to pical application of amphotericin B in 3 cases of bronchial aspergillosis a fter ltx. Two patients are still alive, but 1 died of bleeding from a fistu la between the left upper lobe bronchus and the pulmonary artery. Aspergill osis in the second patient resolved with minimal stenosis of the left main and the left upper lobe bronchus, and the third patient developed an anasto motic stenosis that was successfully dilated.