Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipient
Objectives: This report highlights a clinical case of recurrent diffuse panbronchiolitis (DPB) after bilateral lung transplantation (LTx), with a focus on the therapeutic impact of off-label inhaled tobramycin solution for inhalation (TSI) in managing Pseudomonas aeruginosa colonization. Methods: A...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-07-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225001365 |
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| author | Shin Tanaka Tuyoshi Ryuko Yasuaki Tomioka Kazuhiko Shien Ken Suzawa Kentaroh Miyoshi Hideharu Hagiya Mikio Okazaki Seiichiro Sugimoto Shinichi Toyooka |
| author_facet | Shin Tanaka Tuyoshi Ryuko Yasuaki Tomioka Kazuhiko Shien Ken Suzawa Kentaroh Miyoshi Hideharu Hagiya Mikio Okazaki Seiichiro Sugimoto Shinichi Toyooka |
| author_sort | Shin Tanaka |
| collection | DOAJ |
| description | Objectives: This report highlights a clinical case of recurrent diffuse panbronchiolitis (DPB) after bilateral lung transplantation (LTx), with a focus on the therapeutic impact of off-label inhaled tobramycin solution for inhalation (TSI) in managing Pseudomonas aeruginosa colonization. Methods: A Japanese woman with a history of DPB experienced disease recurrence following bilateral LTx. Persistent colonization by P. aeruginosa and recurrent respiratory symptoms were observed. Off-label TSI therapy, commonly used in cystic fibrosis, was introduced. Clinical response was assessed through radiologic imaging, bronchoscopy, and microbiological cultures. Results: TSI administration led to significant clinical and radiological improvement. P. aeruginosa was eradicated from sputum cultures within one month and remained absent throughout six months of follow-up. No hospitalizations or adverse events were reported during therapy. Conclusion: This case suggests the potential of TSI as a therapeutic approach for managing recurrent DPB and indicates its role in stabilizing post-transplant outcomes. Further studies may clarify its efficacy and expand its application in broader DPB management strategies. |
| format | Article |
| id | doaj-art-98ffa5f36a7f476ea03c93741c1c8358 |
| institution | DOAJ |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-98ffa5f36a7f476ea03c93741c1c83582025-08-20T03:11:26ZengElsevierInternational Journal of Infectious Diseases1201-97122025-07-0115610791310.1016/j.ijid.2025.107913Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipientShin Tanaka0Tuyoshi Ryuko1Yasuaki Tomioka2Kazuhiko Shien3Ken Suzawa4Kentaroh Miyoshi5Hideharu Hagiya6Mikio Okazaki7Seiichiro Sugimoto8Shinichi Toyooka9Department of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital, Okayama, Japan; Corresponding author: Shin Tanaka, Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, Japan.Department of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital, Okayama, JapanDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDepartment of Infectious Diseases, Okayama University Hospital, Okayama, JapanDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital, Okayama, JapanDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanObjectives: This report highlights a clinical case of recurrent diffuse panbronchiolitis (DPB) after bilateral lung transplantation (LTx), with a focus on the therapeutic impact of off-label inhaled tobramycin solution for inhalation (TSI) in managing Pseudomonas aeruginosa colonization. Methods: A Japanese woman with a history of DPB experienced disease recurrence following bilateral LTx. Persistent colonization by P. aeruginosa and recurrent respiratory symptoms were observed. Off-label TSI therapy, commonly used in cystic fibrosis, was introduced. Clinical response was assessed through radiologic imaging, bronchoscopy, and microbiological cultures. Results: TSI administration led to significant clinical and radiological improvement. P. aeruginosa was eradicated from sputum cultures within one month and remained absent throughout six months of follow-up. No hospitalizations or adverse events were reported during therapy. Conclusion: This case suggests the potential of TSI as a therapeutic approach for managing recurrent DPB and indicates its role in stabilizing post-transplant outcomes. Further studies may clarify its efficacy and expand its application in broader DPB management strategies.http://www.sciencedirect.com/science/article/pii/S1201971225001365Inhaled tobramycinLung transplantationPseudomonas aeruginosaRecurrent diffuse panbronchiolitis |
| spellingShingle | Shin Tanaka Tuyoshi Ryuko Yasuaki Tomioka Kazuhiko Shien Ken Suzawa Kentaroh Miyoshi Hideharu Hagiya Mikio Okazaki Seiichiro Sugimoto Shinichi Toyooka Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipient International Journal of Infectious Diseases Inhaled tobramycin Lung transplantation Pseudomonas aeruginosa Recurrent diffuse panbronchiolitis |
| title | Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipient |
| title_full | Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipient |
| title_fullStr | Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipient |
| title_full_unstemmed | Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipient |
| title_short | Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipient |
| title_sort | recurrent diffuse panbronchiolitis after lung transplantation off label use of inhaled tobramycin for pseudomonas aeruginosa control in a transplant recipient |
| topic | Inhaled tobramycin Lung transplantation Pseudomonas aeruginosa Recurrent diffuse panbronchiolitis |
| url | http://www.sciencedirect.com/science/article/pii/S1201971225001365 |
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