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Vol. 34. Issue 3.
Pages 158-161 (March 1998)
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Vol. 34. Issue 3.
Pages 158-161 (March 1998)
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Tratamiento esteroide: factor de riesgo para aspergilosis pulmonar invasiva
Steroid treatment: a risk factor for invasive pulmonary aspergillosis
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S. García García*, C. Álvarez Álvarez
Servicio de Neumología II. Instituto Nacional de Silicosis. Hospital Central de Asturias
Article information

El objetivo de este estudio es describir la asociación entre aspergilosis pulmonar invasiva y tratamiento esteroide en pacientes no inmunodeprimidos por otras causas.

Revisamos las historias clínicas de los pacientes aparentemente no inmunodeprimidos diagnosticados en nuestro hospital de aspergilosis pulmonar invasiva por histología durante los años 1992-1996. Estudiamos a 7 pacientes. Se recogieron los datos clínicos, de laboratorio y radiológicos de cada caso, así como tipo y duración del tratamiento esteroide. En cuanto a enfermedad subyacente, 4 sujetos tenían EPOC, uno arteritis de la temporal, uno fibrosis pulmonar intersticial y otro un tumor neurológico. Todos ellos recibieron tratamiento esteroide durante un período de tiempo comprendido entre unos días y 6 meses, a dosis variable, la mayoría 1mg/kg/día. Todos presentaron un cuadro clínico indicativo de neumonía, cinco de forma extrahospitalaria y dos nosocomial.

La aspergilosis pulmonar invasiva puede aparecer en pacientes mínimamente inmunocomprometidos, como los tratados con corticoides. Hay que sospechar su presencia ante toda neumonía en pacientes que reciban esteroides y no mejoren con tratamiento antibiótico de amplio espectro.

Palabras clave:
Aspergilosis
Corticoides
Neumonía

To describe the association between invasive pulmonary aspergillosis and steroid treatment in patients with no immunodepresion attributable to other causes.

We reviewed the case histories of apparently non immunodepressed patients in our hospital with histological diagnoses of invasive pulmonary aspergillosis between 1992 through 1996. Seven patients were identified. Laboratory, clinical and radiological data were collected, as well as type and duration of steroid treatment.

Four patients suffered underlying chronic obstructive pulmonary disease, 1 had temporal arteritis, 1 interstitial pulmonary fibrosis and 1 a neurological tumor. All had received steroid treatment for periods varying from several days to 16 months, at varying doses, although the majority of them vere treated with 1mg/kg/day. All presented clinical profiles suggestive of pneumonia (5 community acquired and 2 nosocomial).

Invasive pulmonary aspergillosis can appear in minimally immunocompromised patients, such as those undergoing steroid treatment and must be suspected whenever pneumonia is seen in patients receiving steroids who do not improve with widespectrum antibiotic treatment.

Key words:
Aspergillosis
Corticoides
Pneumonia
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Copyright © 1998. Sociedad Española de Neumología y Cirugía Torácica
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