Eficacia de la anfotericina en el tratamiento de histoplasmosis sistémica en pacientes con HIV/SIDA
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2020-10
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Universidad de Guayaquil
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La Histoplasmosis es una enfermedad fúngica oportunista que genera morbilidad y mortalidad en las personas con VIH/SIDA (personas inmunodeprimidas) y no inmunodeprimidos y rara vez en niños, identificado como patógeno humano y poco conocidos en nuestro medio. Objetivo: Conocer los factores de riesgo, caracterizaciones clínicas, manejo terapéutico, evolución, recaídas y curación, de los pacientes ingresados en el Hospital de Infectología “Dr. José D. Rodríguez Maridueña” durante el periodo comprendido entre el 1 de enero de 2000 al 31 de diciembre de 2004. Material y Método: De un universo aproximado de 4.624 pacientes VIH (+), se obtuvo una muestra de 148 casos correspondientes a Histoplasmosis Sistemica. Se efectuó un estudio retrospectivo descriptivo, mediante el programa Epiinfo se analizaron las variables. Resultados: En el estudio está afectado más al sexo masculino, las edades fluctúan entre 31 a 35 años, oriundos de parroquias, cantones y ciudades de la provincia del Guayas. En laboratorio la técnica utilizada fue la tinta china y cultivo de líquido cefalorraquídeo, obteniendo una sensibilidad alta. El tratamiento en la fase aguda fue la Anfotericina B en combinación con Itraconazol y en la fase de recuperación o mantenimiento. En la hipertensión endocraneana se utilizaron soluciones hipertónicas, corticoides y punciones lumbares evacuatorias. La mortalidad fue del 28% y el éxito terapéutico del 18%.
Histoplasmosis is an opportunistic fungal disease that generates morbidity and mortality in people with HIV / AIDS (immunosuppressed people) and non-immunosuppressed and rarely in children, identified as a human pathogen and little known in our environment. Objective: To know the risk factors, clinical characterizations, therapeutic management, evolution, relapses and cure, of patients admitted to the Hospital de Infectología “Dr. José D. Rodríguez Maridueña ” during the period from January 1, 2000 to December 31, 2004. Material and Method: From an approximate universe of 4,624 HIV (+) patients, a sample of 148 cases corresponding to encephalitis was obtained cryptococcal. A descriptive retrospective study was carried out, the variables were analyzed using the Epiinfo program. Results: In the study, the male sex is more affected, the ages fluctuate between 31 to 35 years, originating from parishes, cantons and cities of the province of Guayas. In the laboratory, the technique used was Chinese ink and cerebrospinal fluid culture, obtaining high sensitivity. Treatment in the acute phase was Amphotericin B in combination with Fluconazole and in the recovery or maintenance phase. In intracranial hypertension hypertonic solutions, corticosteroids and evacuatory lumbar punctures were used. Mortality was 28% and therapeutic success was 18%.
Histoplasmosis is an opportunistic fungal disease that generates morbidity and mortality in people with HIV / AIDS (immunosuppressed people) and non-immunosuppressed and rarely in children, identified as a human pathogen and little known in our environment. Objective: To know the risk factors, clinical characterizations, therapeutic management, evolution, relapses and cure, of patients admitted to the Hospital de Infectología “Dr. José D. Rodríguez Maridueña ” during the period from January 1, 2000 to December 31, 2004. Material and Method: From an approximate universe of 4,624 HIV (+) patients, a sample of 148 cases corresponding to encephalitis was obtained cryptococcal. A descriptive retrospective study was carried out, the variables were analyzed using the Epiinfo program. Results: In the study, the male sex is more affected, the ages fluctuate between 31 to 35 years, originating from parishes, cantons and cities of the province of Guayas. In the laboratory, the technique used was Chinese ink and cerebrospinal fluid culture, obtaining high sensitivity. Treatment in the acute phase was Amphotericin B in combination with Fluconazole and in the recovery or maintenance phase. In intracranial hypertension hypertonic solutions, corticosteroids and evacuatory lumbar punctures were used. Mortality was 28% and therapeutic success was 18%.
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MENINGOENCEFALITIS HISTOPLASMOSIS SISTÉMICA, VIH/SIDA, MICOSIS OPORTUNISTAS, NEUROINFECCIÓN
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APA