The Journal of Thoracic and Cardiovascular Surgery, Vol 77, 234-239, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Role of surgery in the management of pulmonary sporotrichosis
JY Jung, CH Almond, DC Campbell, A Elkadi and A Tenorio
Management of four patients with sporotrichosis is summarized; one was
treated medically and three were treated surgically. Thirty-seven cases
from the literature are reviewed. The role of surgery in the management of
pulmonary sporotrichosis is outlined as follows: (1) diagnosis of pulmonary
infiltrates and/or pulmonary cavities of undetermined origin, (2) surgical
intervention in patients with persistent infiltrates with cavitary lesions
resulting from sporotrichosis, following failed medical treatment, and (3)
resection of associated pulmonary cavitary lesions in patients in spite of
adequte medical control of sporotrichosis. Surgical principles that must be
observed in the management of pulmonary sporotrichosis follows:(1)
Resection is the procedure of choice. The magnitude ranges from segmental
resection to pneumonectomy. Clean resection is necessary. (2) Antifungal
drug therapy--preferably with amphotericin B--is advisable preoperatively
and postoperatively, since the major cause of late death is progression of
the disease when clean resection has not been feasible. (3) Resection
combined with drug therapy can be curative without increased risk in
physiologically operable and anatomically resectable disease. (4)
Thoracoplasty can be a lifesaving procedure for bilateral cavitary lesions
with severe hemoptysis in patients with impaired pulmonary functions.
