Trasplantado renal con infección diseminada por Scedosporium apiospermun: reporte de caso y revisión de la literatura
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v82i4.786Palabras clave:
Trasplante renal, infeccion oportunista, Scedosporum apiospermunResumen
Descripción del caso: Mujer de 53 años que recibe trasplante renal de donante cadáver, recibiendo terapia inmunosupresora cuádruple secuencial, posoperatorio inmediato con función retrasada del injerto, sin necesidad de diálisis. Ingresa a los dos meses con clínica de dolor ocular, febrícula y mialgias, de aparición súbita. Se realiza resonancia magnética nuclear que describe lesiones ocupantes de espacio en SNC sugerente de proceso infeccioso y pielonefritis difusa del injerto realizándose trasplantectomía. La paciente fallece a las 24 horas de la intervención a pesar de antibioterapia antifúngica. El cultivo del tejido renal reveló el crecimiento de Scedospotum apiospermun
Relevancia: El caso pone de manifiesto la necesidad del conocimiento y manejo de infecciones de carácter oportunista dado el aumento de pacientes trasplantados con uso de fármacos inmunosupresores.
Implicaciones clínicas: La infección por Scedosporum apiospermun, un hongo oportunista emergente, ubicuo, se presenta como infección sistémica en pacientes inmunodeprimidos que cursa con hasta un 90% de mortalidad y otras formas localizadas que requiere desbridamiento quirúrgico y tratamiento antifúngico de largo tiempo, voriconazol al menos 3 meses.
Conclusiones: Si bien la frecuencia de este tipo de infecciones no es muy alta, su potencial morbimortalidad exige una diagnostico diferencial rápido para instaurar tratamiento adecuado.
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