Perfil microbiológico asociados al derrame pleural en pacientes VIH/SIDA
Fecha
2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Introducción: El derrame pleural (DP) es una patología respiratoria que se
puede presentar por múltiples causas en los pacientes que cursan con el virus de
la inmunodeficiencia humana (VIH), por lo general suele presentarse por causa
de infecciones oportunistas en el momento que el paciente presenta una carga
viral alta y un nivel de CD4 menor a 200 células.
Objetivo: Establecer los microorganismos más frecuentes en el derrame
pleural de origen infeccioso asociados a los pacientes VIH/Positivos.
Metodología: La metodología aplicada a esta investigación es una
metodología observacional, de tipo descriptivo, retrospectivo y de corte
transversal.
Resultados: A partir del universo de 80 pacientes que presentaron el
diagnostico de derrame pleural asociado al VIH, se obtuvo una muestra de 35
casos con microorganismos identificados en el líquido pleural obtenidos del
Hospital de Infectología de Guayaquil entre el 2017 – 2022., no obstante, se
identificó con mayor frecuencia un agente causal el cual es el Mycobacterium con
un 54% de casos asociado a una carga viral entre los 500 a 10000 copias del virus
junto un CD4 menor a 200 células. En los casos revisados, en 45 pacientes no se
pudo identificar ningún microorganismo.
Conclusiones: Se concluyó que la mayoría de los derrames pleurales de
origen infeccioso en pacientes con VIH son secundarios a infecciones oportunista.
Hubo una elevada dificultad para determinar el diagnostico mediante el líquido
pleural debido a que este no es un medio de cultivo adecuado, los pacientes que
llegaron a presentar esta afección, en su gran mayoría tenían una carga viral
mayor a las 40 copias/ml y los niveles de linfocitos TCD4 menos de 200 células
son más frecuentes para que los pacientes con VIH desarrollen una infección
oportunista y se produzca un derrame pleural.
PALABRAS CLAVE: Derrame pleural (DP), Virus de inmunodeficiencia
humana (VIH), Liquido plural (LP), Carga viral (CV), Linfocitos TCD4
Introduction: Pleural effusion (PE) is a respiratory pathology that can occur for multiple reasons in patients with the human immunodeficiency virus (HIV), usually due to opportunistic infections at the time the patient presents a high viral load and a CD4 count of less than 200 cells. Methodology: The methodology applied to this research is an observational, descriptive, retrospective and cross-sectional methodology. Results: From the universe of 80 patients who presented the diagnosis of pleural effusion associated with HIV, a sample of 35 cases was obtained with microorganisms identified in the pleural fluid obtained from the Infectology Hospital of Guayaquil between 2017 - 2022. However, identified more frequently a causal agent which is Mycobacterium with 54% of cases associated with a viral load between 500 to 10,000 copies of the virus together with a CD4 less than 200 cells. Conclusions: It was concluded that the majority of pleural effusions of infectious origin in patients with HIV are secondary to opportunistic infections. There was a high difficulty in determining the diagnosis through pleural fluid because this is not an adequate culture medium, the patients who came to present this condition, the vast majority had a viral load greater than 40 copies/ml and the TCD4 lymphocyte levels less than 200 cells are more frequent for HIV patients to develop an opportunistic infection and a pleural effusion occurs. KEY WORDS: Pleural effusion (PE), Human immunodeficiency virus (HIV), plural liquid (LP), Viral load (VC), TCD4 lymphocytes.
Introduction: Pleural effusion (PE) is a respiratory pathology that can occur for multiple reasons in patients with the human immunodeficiency virus (HIV), usually due to opportunistic infections at the time the patient presents a high viral load and a CD4 count of less than 200 cells. Methodology: The methodology applied to this research is an observational, descriptive, retrospective and cross-sectional methodology. Results: From the universe of 80 patients who presented the diagnosis of pleural effusion associated with HIV, a sample of 35 cases was obtained with microorganisms identified in the pleural fluid obtained from the Infectology Hospital of Guayaquil between 2017 - 2022. However, identified more frequently a causal agent which is Mycobacterium with 54% of cases associated with a viral load between 500 to 10,000 copies of the virus together with a CD4 less than 200 cells. Conclusions: It was concluded that the majority of pleural effusions of infectious origin in patients with HIV are secondary to opportunistic infections. There was a high difficulty in determining the diagnosis through pleural fluid because this is not an adequate culture medium, the patients who came to present this condition, the vast majority had a viral load greater than 40 copies/ml and the TCD4 lymphocyte levels less than 200 cells are more frequent for HIV patients to develop an opportunistic infection and a pleural effusion occurs. KEY WORDS: Pleural effusion (PE), Human immunodeficiency virus (HIV), plural liquid (LP), Viral load (VC), TCD4 lymphocytes.
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DERRAME PLEURAL, VIRUS DE INMUNODEFICIENCIA HUMANA, SINDROME DE INMUNODEFICIENCIA ADQUIRIDA, ESTUDIO OBSERVACIONAL, EPIDEMIOLOGIA DESCRIPTIVA, ESTUDIOS RETROSPECTIVOS, HOSPITAL DE INFECTOLOGIA DR. JOSE DANIEL RODRIGUEZ MARIDUEÑA, CANTON GUAYAQUIL, ECUADOR, LINFOCITOS T CD4-POSITIVOS