Neumonía severa fatal por Pneumocistis jirovecii e Influenza A en un paciente con dermatomiositis amiopática y síndrome antisintetasa
Fatal severe pneumonia caused by Pneumocystis jirovecii and influenza A in a patient with amyopathic dermatomyositis and antisynthetase syndrome
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Tradicionalmente, la neumonía por Pneumocistis jirovecii se ha relacionado con pacientes en estado de inmunodeficiencia marcada, principalmente con infección por virus de inmunodeficiencia humana (VIH). Sin embargo, dada la presencia de ciertas condiciones clínicas como el cáncer, los síndromes linfoproliferativos, los trasplantes (en especial los de órgano sólido), las enfermedades autoinmunes y el uso de medicamentos inmunosupresores para el manejo de estas condiciones, las infecciones por Pneumocistis jirovecii son cada vez más frecuentes a pesar de la profilaxis, que en los países en desarrollo no se cumple a cabalidad en todos los pacientes, lo cual genera mayor morbimortalidad en poblaciones vulnerables. A esto se suma el que las coinfecciones en pacientes inmunosuprimidos son una situación común que empeora su pronóstico. En esta oportunidad se presenta el caso de un paciente con infección por Pneumocistis jirovecii e Influenza A, quien tenía de base diagnóstico de dermatomiositis amiopática y síndrome antisintetasa en tratamiento con esteroides e inmunosupresores.
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