Mucormicosis
DOI:
https://doi.org/10.29176/2590843X.302Palabras clave:
mucormicosis, mucorales, inmunosupresiónResumen
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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