Mucormicosis

  • Nathalie Quiroz
  • Janeth del Pilar Villanueva
  • Edgar Andrés Lozano
Palabras clave: mucormicosis, mucorales, inmunosupresión

Resumen

La mucormicosis es una micosis oportunista y poco frecuente, producida por hongos Zygomicetos del orden Mucorales, asociada con inmunosupresión y de curso agresivo y mortal. Puede dividirse en varios tipos, según el lugar de infección, en rinocerebral (por extensión desde la rinofaringe o por diseminación hematógena), cutánea (más habitualmente en pacientes con diabetes mellitus descompensada, leucemia o cáncer) y pulmonar, entre otras. 
Generalmente, se adquiere por vía respiratoria ya que las esporas de los hongos se encuentran en el ambiente, aunque en las formas cutáneas primarias, la infección se adquiere por solución de continuidad. 
El diagnóstico se confirma con un estudio completo de hongos (examen directo y cultivo para hongos en agar Sabouraud). El estudio anatomo-patológico, aunque permite visualizar perfectamente a los agentes fúngicos, por su demora, no es el método diagnóstico de elección. Una vez hecho el diagnóstico, se debe iniciar un tratamiento temprano, oportuno y adecuado, identificar los factores predisponentes y corregirlos de manera oportuna, ya que esta entidad tiene una alta tasa de mortalidad. 
Se utiliza la anfotericina B como tratamiento de elección que se mantiene hasta estabilizar al paciente y, en las variedades rinocerebrales o pulmonares, se requiere la eliminación quirúrgica del material necrótico. Algunos autores recomiendan el uso de azoles para estas infecciones, sin embargo, el consenso general es que el mejor tratamiento sigue siendo la anfotericina B y los otros antifúngicos están reservados para casos especiales.

Biografía del autor/a

Nathalie Quiroz

Médica dermatóloga, Universidad del Valle, Cali, Colombia

Janeth del Pilar Villanueva

Médica dermatóloga y micóloga; profesora asistente, Sección de Dermatología y Cirugía Dermatológica, Departamento de Medicina Interna, Facultad de Salud, Universidad del Valle. Cali, Colombia

Edgar Andrés Lozano

Médico dermatólogo, Universidad del Valle, Cali, Colombia

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Cómo citar
1.
Quiroz N, Villanueva J del P, Lozano EA. Mucormicosis. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 25 de febrero de 2019 [citado 18 de septiembre de 2021];25(4):284-93. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/302

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Publicado
2019-02-25
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