Interview with CPA patient RW on long term antifungal treatments

A patient interview. This patient RW- with long term chronic pulmonary aspergillosis describes his experiences over 18 years during which he has taken various antifungal treatments. He remains well and currently takes itraconazole. A synopsis is shown below. This patient underwent a lung resection in 1991 for a suspect lesion in his lung, histology revealed inflammation and an area containing fungal hyphae consistent with a fungal ball. Resection appeared to cure the problem. However in 1992 he re-presented with a large new cavity near the site of the surgery and a probable fungal ball seen on X ray. A bronchoscopy sample grew aspergillus and his blood tests were positive for aspergillus precipitins. Chronic pulmonary aspergillosis was diagnosed. Antifungal treatment on itraconazole was started and much improvement was seen. During the next few years the patient tried voriconazole (as a trial drug) – on which he experienced a red facial rash; IV amphotericin – which improved his condition markedly. Itraconazole treatment was then restarted and the patient has been largely stable on this antifungal drug over the last 13 years. On the occasions he has stopped the drug – he has relapsed and it has taken some months before he was again stable. The patient is currently in good health (11/09). We would like to thank the patient for agreeing to share his experiences.