Sección 4. Consenso colombiano para el diagnóstico y tratamiento de los síndromes crónicos, saprofíticos y/o alérgicos asociados a Aspergillus spp., en pacientes adultos y pediátricos

Contenido principal del artículo

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

Resumen

A pesar de la ubicuidad de las especies de Aspergillus, y el hecho que una persona pueda inhalar diariamente cientos de conidios, solo una pequeña proporción de pacientes desarrollan una enfermedad infecciosa. Aspergillus spp. puede causar un amplio espectro de enfermedades, que dependen de la función inmune subyacente del paciente, que incluyen desde un síndrome alérgico, (que no representa una verdadera infección), una reacción de hipersensibilidad (ABPA), un proceso crónico (APC) o una aspergilosis invasora (AI). Todas las enfermedades asociadas con Aspergillus spp., comparten el potencial de ser diagnosticadas erróneamente debido a que los síntomas y/o los hallazgos clínicos se superponen entre sí, o con otras afecciones no fúngicas. Es necesario un mayor reconocimiento clínico de los diferentes síndromes pulmonares, para lograr identificar aquellos pacientes que podrían beneficiarse de un enfoque terapéutico apropiado, lo que requiere de un manejo multidisciplinario, donde el papel del tratamiento antifúngico solo se encuentra establecido para el manejo sintomático y/o progresivo de una enfermedad, teniendo en cuenta el potencial de resistencia a los azoles, que se suma a la complejidad del tratamiento y que en algunos casos, limita las opciones terapéuticas.

Detalles del artículo

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