Aspergilosis invasiva en huésped inmunocomprometido por trasplante hepático. Descripción de caso clínico y revisión de tema

Invasive aspergillosis in an immunocompromised host who had undergone liver transplantation. Case description and subject review

Publicado 2009-03-30

Abrir | Descargar
PDF FLIP
Número
Vol. 21 Núm. 1 (2009)
Sección
Reportes de casos
Cómo citar
Aspergilosis invasiva en huésped inmunocomprometido por trasplante hepático. Descripción de caso clínico y revisión de tema.
rev. colomb. neumol. [Internet]. 2009 Mar. 30 [cited 2024 Nov. 22];21(1):29-38.
DOI
Licencia

Ninguna publicación, nacional o extranjera, podrá reproducir ni traducir sus artículos ni sus resúmenes sin previa autorización escrita del editor; sin embargo  los usuarios pueden descargar la información contenida en ella, pero deben darle atribución o reconocimiento de propiedad intelectual, deben usarlo tal como está, sin derivación alguna.

Julio César Rodríguez Goyes
Residente I año Medicina Interna, Universidad el Bosque, Fundación Santa Fe de Bogotá. Bogotá, Colombia
    Álvaro Morales González
    Neumólogo, FACCP, Departamento de Neumología, Fundación Santa Fe de Bogotá. Bogotá, Colombia.
      Bibiana Andrea Pinzón Valderrama
      Radióloga, Departamento de Radiología e Imágenes Diagnósticas, Fundación Santa Fe de Bogotá. Bogotá, Colombia.
        Diana María Palacios Ortiz
        Patóloga, Departamento de Patología, Fundación Santa Fe de Bogotá. Bogotá, Colombia.
          Mostrar biografía de los autores

          La aspergilosis constituye una de las enfermedades infecciosas que más frecuentemente afecta al paciente con compromiso de su condición inmune. Existen diferentes formas clínicas de presentación, que son más agresivas entre mayor grado de inmunosupresión. El diagnóstico es desafiante y en ocasiones requiere una alta sospecha, así como la integración de varios factores, todos ellos basados en una juiciosa historia clínica, análisis de factores de riesgo, cuadro clínico, imágenes diagnósticas, estudio histopatológico, pruebas serológicas y cultivos. Debido a la agresividad de esta infección, es importante hacer un diagnóstico temprano, sea probable o definitivo, buscando iniciar rápidamente el tratamiento antimicótico para disminuir la morbimortalidad. En los últimos 20 años ha existido un importante desarrollo de un sinnúmero de estrategias diagnósticas, principalmente de estudios serológicos, para mejorar el diagnóstico de esta entidad; de igual forma, el antiguo tratamiento con anfotericina B ahora ha virado hacia el uso de voriconazol con muchos mejores resultados.

          Visitas del artículo 115 | Visitas PDF 207

          Descargas

          Los datos de descarga todavía no están disponibles.
          1. Mackenzie DW. Aspergillus in man. In: Vanden Bossche H, Mackenzie DWR, Cauwenbergh G, ed. Proceedings of the Second International Symposium on Topics in Mycology, Antwerp, Belgium: University of Antwerp; 1987. p. 1-8.
          2. Denning DW. Invasive aspergillosis. Clin Infect Dis 1998; 26:781-803.
          3. Walsh TJ, Dixon DM: Nosocomial aspergillosis: Environmental microbiology, hospital epidemiology, diagnosis and treatment. Eur J Epidemiol 1989; 5:131-42.
          4. Mason R, Murray J, Nadel J. Textbook of Respiratory Medicine. 2005 Saunders. An Imprint of Elsevier 4th Ed.
          5. Fauci A, Braunwald E, Kasper D. Harrison’s Principles of Internal Medicine. McGraw Hill. 17 Ed. U.S.A. 2008.
          6. McNeil MM, Nash SL, Hajjeh RA, Phelan MA, Conn LA, Plikaytis BD, Warnock DW. Trends in mortality due to invasive mycotic diseases in the United States, 1980-1997. Clin Infect Dis 2001; 33: 641-7.
          7. Denning DW. Introduction: the Aspergillus fumigatus genome database. Vol. 2003: The Institute for Genomic Research (TIGR). Available from: ww.tigr.org/tdb/e2k1/afu1/intro.shtml (accessed 2003).
          8. Stevens DA, Kan VL, Judson MA, et al. Practice guidelines for diseases caused by Aspergillus. Clin Infect Dis 2000; 30:696-709.
          9. Von Eiff M, Roos N, Schulten R, et al. Pulmonary aspergillosis: Early diagnosis improves survival. Respiration 1995; 62: 341-7.
          10. Brahm H, Segal, Walsh T. Current approaches to diagnosis and treatment of invasive aspergillosis. Am J Respir Crit Care Med 2006; 173: 707-17.
          11. DeRepentigny L, Petitbois S, Boushira M, et al. Acquired immunity in experimental murine aspergillosis is mediated by macrophages. Infect Immunol 1993; 61: 3791-802.
          12. Duong M, Ouellet N, Simard M, et al. Kinetic study of host defense and inflammatory response to Aspergillus fumigatus in steroid-induced immunosuppressed mice. J Infect Dis 1998; 178: 1472-82.
          13. Schaffner A. Macrophage-Aspergillus interactions. Immunology 1994; 60: 545--52.
          14. Schaffner A, Douglas H, Braude AI, et al. Killing of Aspergillus spores depends on the anatomical source of the macrophage. Infect Immunol 1983; 42: 1109-15.
          15. Waldorf AR, Levitz SM, Diamond RD. In vivo bronchoalveolar macrophage defense against Rhizopus oryzae and Aspergillus fumigatus. J Infect Dis 1984;150:752-60.
          16. Allen M, Harbeck R, Smith B, et al. Binding of rat and human surfactant proteins A and D to Aspergillus fumigatus conidia. Infect Immunol 1999;67:4563-9.
          17. Crosdale DJ, Poulton KV, Ollier WE, et al. Mannose-binding lectin gene polymorphisms as a susceptibility factor for chronic necrotizing pulmonary aspergillosis. J Infect Dis 2001; 184: 653-6.
          18. Marr K, Patterson T, Denning D. Aspergillosis pathogenesis, clinical manifestations, and therapy. Infect Dis Clin N Am 2002; 16: 875-89.
          19. Mandell G, Bennet J, Dolin R. Principles and practice of infectious diseases. Churchill Livingstone. 6th Ed. Philadelphia. 2005.
          20. Gerson SL, Talbot GH, Hurwitz S, et al. Prolonged granulocytopenia: The major risk factor for invasive pulmonary aspergillosis in patients with acute leukemia. Ann Intern Med 1984; 100:345-51.
          21. Yeghen T, Kibbler CC, Prentice HG, et al. Management of invasive pulmonary aspergillosis in hematology patients: A review of 87 consecutive cases at a single institution. Clin Infect Dis 2000; 31: 859-68.
          22. Von Eiff M, Roos N, Schulten R, et al. Pulmonary aspergillosis: Early diagnosis improves survival. Respiration 1995; 62: 341-7.
          23. Caillot D, Casasnovas O, Bernard A, et al. Improved management of invasive pulmonary aspergillosis in neutropenic patients using early thoracic computed tomographic scan and surgery. J Clin Oncol 1997; 15: 139-47.
          24. Greene RE, Schlamm HT, Stark P, et al. Radiological findings in acute invasive pulmonary aspergillosis: Utility and reliability of halo sign and air-crescent sign for diagnosis and treatment of IPA in high-risk patients (Abstract O397). Program of the 13th European Congress of Clinical Microbiology and Infectious Diseases. Glasgow, Scotland, May 2003.
          25. Shaukat A, Bakri F, Young P, Hahn T, Ball D, Baer MR, et al. Invasive filamentous fungal infections in allogeneic hematopoietic stem cell transplant recipients after recovery from neutropenia: clinical, radiologic, and pathologic characteristics. Mycopathologia 2005; 159: 181-8.
          26. Levine SJ. An approach to the diagnosis of pulmonary infections in immunosuppressed patients. Semin Respir Infect 1992;7: 81-95.
          27. Horvath JA, Dummer S. The use of respiratory-tract cultures in the diagnosis of invasive pulmonary aspergillosis. Am J Med 1996; 100: 171-8.
          28. Yu VL, Muder RR, Poorsattar A. Significance of isolation of aspergillus from the respiratory tract in diagnosis of invasive pulmonary aspergillosis: Results from a three-year prospective study. Am J Med 1986; 81: 249-54.
          29. Young RC, Bennett JE: Invasive aspergillosis. Absence of detectable antibody response. Am Rev Resp Dis 1971; 104: 710-6.
          30. Maertens J, Verhaegen J, Lagrou K, et al. Screening for circulating galactomannan as a noninvasive diagnostic tool for invasive aspergillosis in prolonged neutropenic patients and stem cell transplantation recipients: A prospective validation. Blood 2001; 97: 1604-10.
          31. Verweij PE, Erjavec Z, Sluiters W, et al. Detection of antigen in sera of patients with invasive aspergillosis: Intra- and interlaboratory reproducibility. J Clin Microbiol 1998; 36: 1612-6.
          32. Verweij PE, Stynen D, Rijs AJMM, et al. Sandwich enzyme-linked immunosorbent assay compared with Pastorex latex agglutination test for diagnosing invasive aspergillosis in immunocompromised patients. J Clin Microbiol 1995; 33: 1912-4.
          33. Maertens J, Verhaegen J, Demuynck H, et al. Autopsycontrolled prospective evaluation of serial screening for circulating galactomannan by a sandwich enzyme-linked immunosorbent assay for hematological patients at risk for invasive aspergillosis. J Clin Microbiol 1999; 37: 3223-8.
          34. Sulahian A, Tabouret M, Ribaud P, et al. Comparison of an enzyme immunoassay and latex agglutination test for detection of galactomannan in the diagnosis of aspergillosis. Eur J Clin Microbiol Infect Dis 1996; 15: 139-45.
          35. Musher B, Fredricks D, Leisenring W, et al. Aspergillus galactomannan enzyme immunoassay and quantitative PCR for diagnosis of invasive aspergillosis with bronchoalveolar lavage fluid. J Clin Microbiol 2004; 42(12): 5517–22.
          36. Sulahian A, Touratier S, Leblanc T, et al. False positive Aspergillus antigenemia related to concomitant administration of tazocillin (Abstract M-2062a). Abstracts of the 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, September 14-17, Washington, D.C.: American Society for Microbiology; 2003.
          37. Viscoli C, Machetti M, Cappellano P, et al. False-positive platelia Aspergillus (PA) test in patients (pts) receiving piperacillintazobactam (P/T) (Abstract M-2062b). Abstracts of the 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, September 14–17, Washington, D.C., American Society for Microbiology, 2003.
          38. Sulahian A, Touratier S, Ribaud P. False positive test for Aspergillus antigenemia related to concomitant administration of piperacillin and tazobactam. N Engl J Med 2003; 349: 2366-7.
          39. Marr KA, Balajce SA, McLaughlin L, et al. Detection of galactomannan antigenemia by enzyme immunoassay for the diagnosis of invasive aspergillosis: variables that affect performance. J Infect Dis 2004; 190: 641-9.
          40. Fortun J, Martin-Davila P, Alvarez ME, et al. Aspergillus antigenemia sandwich-enzyme immunoassay test as a serodiagnostic method for invasive aspergillosis in liver transplant recipients. Transplantation 2001; 71: 145-9.
          41. Kwak EJ, Husain S, Obman A, et al. Efficacy of galactomannan antigen in the Platelia Aspergillus enzyme immunoassay for diagnosis of invasive aspergillosis in liver transplant recipients. J Clin Microbiol 2004; 42: 435-8.
          42. Husain S, Kwak EJ, Obman A, et al. Prospective assessment of Platelia Aspergillus galactomannan antigen for the diagnosis of invasive aspergillosis in lung transplant recipients. Am J Transplant 2004; 4: 796-802.
          43. Ostrosky-Zeichner L, Alexander BD, Kett DH, et al. Multicenter clinical evaluation of the (1®3) beta D-glucan assay as an aid to diagnosis of fungal infections in humans. Clin Infect Dis 2005; 41: 654-9.
          44. Halliday C, Hoile R, Sorrell T, et al. Role of prospective screening of blood for invasive aspergillosis by polymerase chain reaction in febrile neutropenic recipients of haematopoietic stem cell transplants and patients with acute leukaemia. Br J Haematol 2006;132:478-86.
          45. Stevens DA, Kan VL, Judson MA, et al. Practice guidelines for diseases caused by Aspergillus. Clin Infect Dis 2000; 30:696-709.
          46. Patterson TF, Kirkpatrick WR, White M, et al. Invasive aspergillosis. Disease spectrum, treatment practices, and outcomes. I3 Aspergillus Study Group. Medicine (Baltimore) 2000; 79:250-60.
          47. Herbrecht R, Denning DW, Patterson TF, et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002; 347:408-15.
          48. Wingard JR, Kubilis P, Lee L, et al. Clinical significance of nephrotoxicity in patients treated with amphotericin B for suspected or proven aspergillosis. Clin Infect Dis 1999; 29: 1402-7.
          49. Ostrosky-Zeichner L, Marr KA, Rex JH, Cohen SH, Amphotericin B. Time for a new «gold standard». Clin Infect Dis 2003; 37: 415-25.
          50. Steinbach WJ, Stevens DA. Review of newer antifungal and immunomodulatory strategies for invasive aspergillosis. Clin Infect Dis 2003; 37(Suppl 3): S157-87.
          51. Denning DW, Ribaud P, Milpied N, et al. Efficacy and safety of voriconazole in the treatment of acute invasive aspergillosis. Clin Infect Dis 2002; 34: 563-71.
          52. Bates DW, Su L, Yu DT, et al. Mortality and costs of acute renal failure associated with amphotericin B therapy. Clin Infect Dis 2001; 32: 686-93.
          53. Wingard JR, Kubilis P, Lee L, et al. Clinical significance of nephrotoxicity in patients treated with amphotericin B for suspected or proven aspergillosis. Clin Infect Dis 1999; 29: 1402-7.
          54. Barrett JP, Vardulaki KA, Conlon C, et al. A systematic review of the antifungal effectiveness and tolerability of amphotericin B formulations. Clin Ther 2003; 25:1295-320.
          55. Leenders ACAP, Daenen S, Jansen RLH, et al. Liposomal amphotericin B compared with amphotericin B deoxycholate in the treatment of documented and suspected neutropenia associated invasive fungal infections. Br J Haematol 1998; 103: 205-12.
          56. Walsh TJ, Hiemenz JW, Seibel NL, et al. Amphotericin B lipid complex for invasive fungal infections: Analysis of safety and efficacy in 556 cases. Clin Infect Dis 1998; 26: 1383-96.
          57. Linden PK, Coley K, Fontes P, et al. Invasive aspergillosis in liver transplant recipients: Outcome comparison of therapy with amphotericin B lipid complex and a historical cohort treated with conventional amphotericin B. Clin Infect Dis 2003; 37: 17-25.
          58. Bowden R, Chandrasekar P, White MH, et al. A double-blind, randomized, controlled trial of amphotericin B colloidal dispersion versus amphotericin B for treatment of invasive aspergillosis in immunocompromised patients. Clin Infect Dis 2002; 35: 359-66.
          59. Patterson TF, Kirkpatrick WR, White M, et al. Invasive aspergillosis. Disease spectrum, treatment practices, and outcomes. I3 Aspergillus Study Group. Medicine (Baltimore) 2000; 79: 250-60.
          60. Caillot D, Bassaris H, McGeer A, et al. Intravenous itraconazole followed by oral itraconazole in the treatment of invasive pulmonary aspergillosis in patients with hematologic malignancies, chronic granulomatous disease, or AIDS. Clin Infect Dis 2001; 33: E83-E90.
          61. Maertens J, Raad I, Sable CA, et al. Multicenter, noncomparative study to evaluate safety and efficacy of caspofungin in adults with aspergillosis refractory or intolerant to amphotericin B, amphotericin B lipid formulations, or azoles. 40th Interscience Conference on Antimicrobial Agents and Chemotherapy. Toronto, Canada; 2000.
          62. Kirkpatrick WR, Perea S, Coco BJ, Patterson TF: Efficacy of caspofungin alone and in combination with voriconazole in a guinea pig model of invasive aspergillosis. Antimicrob Agents Chemother 2002; 46: 2564-8.
          63. Steinbach WJ, Stevens DA: Review of newer antifungal and immunomodulatory strategies for invasive aspergillosis. Clin Infect Dis 2003; 37(Suppl 3):S157-87.
          64. Herbrecht R, Denning DW, Patterson TF, et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002; 347: 408-15.
          65. Ally R, Schurmann D, Kreisel W, et al. A randomized, double blind, double-dummy, multicenter trial of voriconazole and fluconazole in the treatment of esophageal candidiasis in immunocompromised patients. Clin Infect Dis 2001; 33: 1447-54.
          66. Walsh TJ, Pappas P, Winston DJ, et al. Voriconazole compared with liposomal amphotericin B for empirical antifungal therapy in patients with neutropenia and persistent fever. N Engl J Med 2002; 346: 225-34

          Información

          Historia de la revista

          Palabras clave

          Código QR

          Patrocinadores

           Nos apoyan +Info Aquí 

           

          Directorios e indexadores

           

          Perfil de Google Scholar

          Más leídos en los últimos 30 días

          Número actual

          Sistema OJS 3.4.0.7 - Metabiblioteca |