Aspergiloma pulmonar en paciente con síndrome de sobreposición: Reporte de caso
Pulmonary aspergiloma in patient with overposition syndrome: Case's report
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Rozo Ortiz EJ, Vargas Rodriguez LJ, Agudelo Sanabria MB. Aspergiloma pulmonar en paciente con síndrome de sobreposición: Reporte de caso. Revista Investig. Salud Univ. Boyacá [Internet]. 11 de enero de 2019 [citado 19 de abril de 2024];6(1):188-9. Disponible en: https://revistasdigitales.uniboyaca.edu.co/index.php/rs/article/view/303
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Introducción: La infección por Aspergillus spp. representa un reto diagnóstico y terapéutico para el clínico, puesto que existe un número aproximado de 180 especies. El pulmón es el principal órgano afectado por el Aspergillus debido a la alta capacidad esporulativa de este hongo, y a que sus conidias son lo suficientemente pequeñas para poder alcanzar el alveolo. Caso: Mujer de 41 años de edad con antecedente de lupus eritematoso sistémico, ingresó con un cuadro de disfagia, en el cual se confirmó la presencia de síndrome de sobreposición mediante perfil inmunológico. Posteriormente, mediante estudio imagenológico, realizado por tener tos y disnea, se encontró la presencia de una masa ovoidea en hemitorax derecho y al realizar una fibrobroncoscopia se evidenció que dicha lesión era compatible con un aspergiloma, por lo que se dio manejo antifúngico con una evolución clínica adecuada. Conclusión: El aspergiloma se presenta como una masa voluminosa constituida por filamentos miceliales, la cual se puede confundir con múltiples patologías principalmente de tipo tumoral, por lo que es necesario realizar biopsia de la misma.
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2. Guyatt GH, Oxman AD, Schunemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011; 64 (3):380–2. https://doi.org/10.1016/j.jclinepi.2010.09.011
3. Panackal AA, Li H, Kontoyiannis DP, et al. Geoclimatic influences on invasive aspergillosis after hematopoietic stem cell transplantation. Clin Infect Dis. 2010; 50 (8):1588–97. https://dx.doi.org/10.1086%2F652761
4. Maturu VN, Agarwal R. Reversed halo sign: a systematic review. Respir Care 2014; 59:1440–9. https://doi.org/10.4187/respcare.03020
5. Pohl C, Jugheli L, Haraka F, Mfinanga E, Said K, Reither K. Pulmonary aspergilloma: a treatment challenge in sub-Saharan Africa, PLoS Negl. Trop. Dis. 2013; 7: 2352 - 10. https://doi.org/10.1371/journal.pntd.0002352
6. Valle J, González F, Álvarez J, Valdés L. La aspergilosis pulmonar invasiva en la enfermedad pulmonar obstructiva crónica. Rev Med Chile. 2010; 138: 612-620. https://scielo.conicyt.cl/pdf/rmc/v138n5/art13.pdf
7. Bustamante B, Denning D, Campos E. Serious fungal infections in Peru. Eur J Clin Microbiol Infect Dis. 2017; 36(6):943-948. https://doi.org/10.1007/s10096-017-2924-9
8. Kaya S, Gençalioğlu E, SönMez M, KökSal S. The importance of risk factors for the prediction of patients with invasive pulmonary aspergillosis. Rev Assoc Med BRAs 2017; 63(9):764-770. https://doi.org/10.1590/1806-9282.63.09.764
9. Jhun BW, Jung WJ, Hwang NY, Park HY, Jeon K, Kang E, et al. Risk factorsfor the development of chronic pulmonary aspergillosis in patients with nontuberculous mycobacterial lung disease. PLoS ONE. 2017; 12(11):1887-16. https://doi.org/10.1371/journal.pone.0188716
10. Patterson TF, Thompson GR, Denning DW, Fishman JA, Hadley S, Herbrecht R, et al. Practice Guidelines for the Diagnosis and Management of Aspergillosis: Update by the Infectious Diseases Society of America. Clinical Infectious Diseases. 2016; 63 (1): 1 – 60. https://doi.org/10.1093/cid/ciw326
11. Taccone FS, Van den Abeele AM, Bulpa P, Misset B, Meersseman W, Cardoso T, et al. Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes. Critical Care. 2015; 19:7 – 15. https://dx.doi.org/10.1186%2Fs13054-014-0722-7
12. Kovanda LL, Desai AV, Hope WW. Prognostic value of galactomannan: current evidence for monitoring response to antifungal therapy in patients with invasive aspergillosis. J Pharmacokinet Pharmacodyn. 2017; 8: 1007 – 15. https://doi.org/10.1007/s10928-017-9509-1
13. Metan G, Keklik M, Dinç G, Pala Ç, Yıldırım A, Saraymen B, et al. Performance of Galactomannan Antigen, Beta-d-Glucan, and Aspergillus-Lateral-Flow Device for the Diagnosis of Invasive Aspergillosis. Indian J Hematol Blood Transfus. 2017; 33(1):87-92. https://doi.org/10.1007/s12288-016-0653-3
14. Cruciani M, Mengoli C, Loeffler J, Donnelly P, Barnes R, Jones BL, et al. Polymerase chain reaction blood tests for the diagnosis of invasive aspergillosis in immunocompromised people. Cochrane Database Syst Rev. 2015; 7;(9): 551 – 21. https://doi.org/10.1002/14651858.CD009551.pub2
15. Aguado JM, Vázquez L, Fernández-Ruiz M, Villaescusa T, Ruiz-Camps I, Barba P, et al. Serum galactomannan versus a combination of galactomannan and polymerase chain reaction-based Aspergillus DNA detection for early therapy of invasive aspergillosis in highrisk hematological patients: a randomized controlled trial. Clin Infect Dis. 2015; 60:405–415. https://doi.org/10.1093/cid/ciu833
16. Sampsonas F, Kontoyiannis DP, Dickey BF, Evans SE. Performance of a standardized bronchoalveolar lavage protocol in a comprehensive cancer center: a prospective 2-year study. Cancer 2011; 117:3424–33. https://dx.doi.org/10.1002%2Fcncr.25905
17. Maertens JA, Raad II, Marr KA, Patterson TF, Kontoyiannis DP, Cornely OA, et al. Isavuconazole versus voriconazole for primary treatment of invasive mould disease caused by Aspergillus and other filamentous fungi (SECURE): a phase 3, randomised-controlled, non-inferiority trial. Lancet 2016; 387:760–9. https://doi.org/10.1016/S0140-6736(15)01159-9
18. Lowes D, Al-Shair K, Newton PJ, Morris J, Harris C1 Rautemaa-Richardson R, et al. Predictors of mortality in chronic pulmonary aspergillosis. European Respiratory Journal. 2017; 49 (3): 160 – 15. https://doi.org/10.1183/13993003.01062-2016
19. Salzer HJ, Cornely OA. Awareness of predictors of mortality may help improve outcome in chronic pulmonary aspergillosis. European Respiratory Journal. 2017; 49 (16): 205 - 8. https://doi.org/10.1183/13993003.02520-2016
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