Protocolo diagnóstico del paciente inmunocomprometido febril con infiltrados pulmonares

  1. Pérez Galera, S. 1
  2. Girón Ortega, J.A. 1
  3. Pérez Cortés, S. 2
  4. Girón González, J.A. 3
  1. 1 Servicio de Medicina Interna. Hospital Universitario Virgen Macarena. Sevilla. España
  2. 2 Servicio de Enfermedades Infecciosas. Hospital Universitario de Jerez. Cádiz. España
  3. 3 Servicio de Medicina Interna General, Enfermedades Infecciosas y Cuidados Paliativos. Hospital Universitario Puerta del Mar. Cádiz. España
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2022

Título del ejemplar: Enfermedades infecciosas (V)

Serie: 13

Número: 53

Páginas: 3136-3142

Tipo: Artículo

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumen

The introduction of new therapies for oncological and autoimmune diseases as well as the increase in survival of transplanted patients or patients with HIV infection has given rise to an increase in immunocompromised patients who consult for febrile syndrome and pulmonary infiltrates. The etiology of the symptoms includes immune reactions, involvement of the neoplasm itself, or infectious diseases. In the case of infectious diseases, the germs can be similar to those of immunocompetent patients. However, we often find other opportunistic pathogens (Listeria spp., Nocardia spp., Pneumocistis jirovecii, or Apergillus spp.). Depending on clinical suspicion, we will conduct a diagnostic approach that includes non-invasive tests (stains, cultures, and polymerase chain reactions —PCR— in sputum) and other invasive tests such as a bronchoscopy with bronchoalveolar lavage or a lung biopsy in order to make an etiological diagnosis and initiate targeted treatment.

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