Determinación de histoplasmosis en aspirado de médula ósea en pacientes con VIH en el Hospital de Infectología Dr. José Daniel Rodríguez Maridueña de enero a diciembre del año 2014
Fecha
2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
La histoplasmosis es una micosis sistémica. Esta micosis producida por el hongo dimorfo Histoplasma capsulatum var. Capsulatum vive en tierras ricas en sustancias orgánicas, con excretas de aves y murciélagos estimula la proliferación y esporulación de Histoplasma los microconidios de la forma micelial se dispersan en aerosol e infectan al hombre y de animales. Los pacientes con SIDA, linfomas, infecciones por CMV, los receptores de trasplantes de órganos y los que están bajo tratamiento de corticosteroides u otras drogas inmunosupresoras, presentan infecciones progresivas y diseminadas que suelen tener un curso fatal cuando no son diagnosticadas y tratadas. En estos casos las lesiones se sitúan en las mucosas, la piel, ganglios linfáticos, el hígado, bazo, suprarrenales, medula ósea, SNC. El diagnóstico de la histoplasmosis diseminada a medula ósea se efectúa por el Hallazgo del agente causal en el aislamiento en cultivos, por aspiración de medula ósea. Encontrándose histoplasmosis diseminada a medula 19 casos de 28 pacientes que corresponde un 67.85% de pacientes, más frecuente en sexo masculino 14 casos en un 73.68%, con predominio en pacientes jóvenes 20 – 30 años 6 casos correspondiente 31.57%, en los meses de enero y febrero 15.78% y con prevalencia a pacientes inmunodeprimidos con un CD4 bajo por lo que presento otras infecciones oportunistas. Los pacientes hospitalizados en áreas de mayor complejidad por su estado es donde hemos encontrado mayores casos UCI 26.31% y en la sala de Varones-2 47.36%. Por ello es necesario realizar un proceso investigativo retrospectivo de los últimos 10 años para tener una base de datos más fidedigna que ayudara al trabajo de investigación. Los pacientes con histoplasmosis diseminada a medula ósea deben recibir el tratamiento completo de anfotericina ingresado en el hospital. A todo paciente con histoplasmosis diseminada a medula ósea realizársele por lo menos cada 3 meses un nuevo examen de diagnóstico en este caso de medula ósea para ver si el tratamiento que ha recibido es el correcto y en dosis adecuadas.
ABSTRACT
Histoplasmosis is a systemic fungal infection. This mycosis caused by the dimorphic fungus Histoplasma capsulatum var. Capsulatum lives in lands rich in organic matter, excreta of birds and bats stimulates proliferation and sporulation of microconidia of Histoplasma mycelial form are dispersed in aerosol and infect humans and animals. AIDS patients, lymphoma, CMV infections, recipients of organ transplants and those under treatment of corticosteroids or other immunosuppressive drugs, have progressive and disseminated infections that often have a fatal course when they are not diagnosed and treated. In these cases the lesions are located in mucous membranes, skin, lymph nodes, liver, spleen, adrenal, bone marrow, CNS. The diagnosis of disseminated histoplasmosis bone marrow is made by the finding of the causal agent in isolation in culture, bone marrow aspiration. Finding disseminated histoplasmosis cord 19 cases of 28 patients 67.85% corresponds to a patient, more frequent in males in 14 cases 73.68%, predominantly in young patients 20-30 years 6 corresponding 31.57% cases in the months of January and February and 15.78% prevalence of immunocompromised patients with low CD4 so I present other opportunistic infections. Hospitalized patients in areas of greater complexity for its state is where we found older cases UCI 26.31% and in the living Men-2 47.36%. It is therefore necessary to conduct a retrospective investigation process of the last 10 years to have a base of more reliable data to assist the research. Patients with disseminated histoplasmosis bone marrow should receive the full course of amphotericin admitted to the hospital. All patients with disseminated histoplasmosis bone marrow realizársele at least every three months a new diagnostic test in this case bone marrow to see if the treatment you received is correct and in adequate doses.
ABSTRACT Histoplasmosis is a systemic fungal infection. This mycosis caused by the dimorphic fungus Histoplasma capsulatum var. Capsulatum lives in lands rich in organic matter, excreta of birds and bats stimulates proliferation and sporulation of microconidia of Histoplasma mycelial form are dispersed in aerosol and infect humans and animals. AIDS patients, lymphoma, CMV infections, recipients of organ transplants and those under treatment of corticosteroids or other immunosuppressive drugs, have progressive and disseminated infections that often have a fatal course when they are not diagnosed and treated. In these cases the lesions are located in mucous membranes, skin, lymph nodes, liver, spleen, adrenal, bone marrow, CNS. The diagnosis of disseminated histoplasmosis bone marrow is made by the finding of the causal agent in isolation in culture, bone marrow aspiration. Finding disseminated histoplasmosis cord 19 cases of 28 patients 67.85% corresponds to a patient, more frequent in males in 14 cases 73.68%, predominantly in young patients 20-30 years 6 corresponding 31.57% cases in the months of January and February and 15.78% prevalence of immunocompromised patients with low CD4 so I present other opportunistic infections. Hospitalized patients in areas of greater complexity for its state is where we found older cases UCI 26.31% and in the living Men-2 47.36%. It is therefore necessary to conduct a retrospective investigation process of the last 10 years to have a base of more reliable data to assist the research. Patients with disseminated histoplasmosis bone marrow should receive the full course of amphotericin admitted to the hospital. All patients with disseminated histoplasmosis bone marrow realizársele at least every three months a new diagnostic test in this case bone marrow to see if the treatment you received is correct and in adequate doses.
ABSTRACT Histoplasmosis is a systemic fungal infection. This mycosis caused by the dimorphic fungus Histoplasma capsulatum var. Capsulatum lives in lands rich in organic matter, excreta of birds and bats stimulates proliferation and sporulation of microconidia of Histoplasma mycelial form are dispersed in aerosol and infect humans and animals. AIDS patients, lymphoma, CMV infections, recipients of organ transplants and those under treatment of corticosteroids or other immunosuppressive drugs, have progressive and disseminated infections that often have a fatal course when they are not diagnosed and treated. In these cases the lesions are located in mucous membranes, skin, lymph nodes, liver, spleen, adrenal, bone marrow, CNS. The diagnosis of disseminated histoplasmosis bone marrow is made by the finding of the causal agent in isolation in culture, bone marrow aspiration. Finding disseminated histoplasmosis cord 19 cases of 28 patients 67.85% corresponds to a patient, more frequent in males in 14 cases 73.68%, predominantly in young patients 20-30 years 6 corresponding 31.57% cases in the months of January and February and 15.78% prevalence of immunocompromised patients with low CD4 so I present other opportunistic infections. Hospitalized patients in areas of greater complexity for its state is where we found older cases UCI 26.31% and in the living Men-2 47.36%. It is therefore necessary to conduct a retrospective investigation process of the last 10 years to have a base of more reliable data to assist the research. Patients with disseminated histoplasmosis bone marrow should receive the full course of amphotericin admitted to the hospital. All patients with disseminated histoplasmosis bone marrow realizársele at least every three months a new diagnostic test in this case bone marrow to see if the treatment you received is correct and in adequate doses.
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Histoplasmosis, Médula ósea, Micosis, Virus de inmunodeficiencia humana, Hospital de Infectología Dr. José Daniel Rodríguez Maridueña, Cantón Guayaquil, Ecuador