Sección 3. Consenso colombiano para el diagnóstico y tratamiento la aspergilosis extrapulmonar en pacientes adultos

Contenido principal del artículo

José M. Oñate
Ximena Castañeda-Luquerna
Pilar Rivas-Pinedo
Jorge I. Marín-Uribe Marín-Uribe
Indira Berrio
Hugo Fernández-Suarez
Juan P. Osorio-Lombana
Sonia I. Cuervo-Maldonado
Carlos H. Saavedra-Trujillo
Adriana Marcela Celis
Carlos A. Álvarez-Moreno
Julio C. Gómez-Rincón
Sonia Restrepo-Gualteros
Germán Camacho-Moreno
Leonardo Enciso-Olivera
Bonell Patiño-Escobar
Fredy Guevara
Jaime Patiño-Niño
Franco Montufar
Eduardo López-Medina
Dinno Fernández-Chico
José F. García-Goez
Christian Pallares G

Resumen

Las manifestaciones clínicas de las enfermedades asociadas con Aspergillus spp. son variables y dependen de la interacción entre la dosis de inoculación (que se desconoce y probablemente varía ampliamente), la capacidad del paciente para resistir la infección a nivel local y sistémico, y la virulencia del agente etiológico, donde la mayor dificultad para establecer un esquema de clasificación clínica radica en la existencia de un espectro amplio y continuo de enfermedad, asociado a un diagnóstico y manejo clínico complicado. Una aspergilosis invasiva (AI) puede presentarse como una infección localizada en un órgano, o como parte de una infección diseminada, que se presentan en un variado espectro de cuadros clínicos, sin embargo, no se han completado ensayos clínicos que evalúen los diferentes abordajes terapéuticos específicos, de acuerdo al tipo de compromiso en estos pacientes. Las formas clínicas más comunes de AI tienen lugar a nivel de pulmón y de senos paranasales, una aspergilosis pulmonar crónica (APC) puede complicarse al extenderse a estructuras contiguas como el espacio pleural, el pericardio, la pared torácica y las estructuras mediastínicas como el esófago y los grandes vasos. La capacidad de diseminación más allá del tracto respiratorio es frecuente, y puede comprometer afectar piel, SNC, ojos, hígado, riñones y otras estructuras.

Detalles del artículo

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