Vol. 12. Núm. 64.
Páginas 3770-3779 (Octubre 2018)

Infecciones broncoalveolares crónicas

Chronic bronchoalveolar infections

A. Ampuero LópezD. Gaziani Noriega
Doi : https://10.1016/j.med.2018.10.004
Opciones
Resumen

Es la afectación del tracto respiratorio persistente, secundaria a patologías infecciosas, que suele tener un tratamiento complejo por su difícil diagnóstico. Son múltiples las etiologías responsables y presenta una gran morbimortalidad en la actualidad. En las últimas décadas han aumentado las tasas de TBC resistente a fármacos, suponiendo una amenaza para la salud pública. Otra causa frecuente de infección e inflamación bronquial crónica son las bronquiectasias, dilataciones anormales e irreversibles de los bronquios con alteración del epitelio ciliar. El tratamiento se basa en intentar eliminar la causa que las produce y abordar las infecciones. Por otro lado, debemos saber que los pacientes inmunodeprimidos son más susceptibles a contraer infecciones oportunistas como micosis y nocardia. Son enfermedades graves con elevada mortalidad, por lo que el diagnóstico y el tratamiento precoces cobran un papel clave en el manejo de estas infecciones. Con respecto al tratamiento, debemos tener en cuenta que no depende exclusivamente de los antifúngicos sino que deberemos revertir o reducir el grado de inmunosupre-sión para alcanzar la curación.

Keywords
Tuberculosis
Mycoses
Aspergillosis
Nocardiosis
Palabras clave
Tuberculosis
Micosis
Aspergilosis
Nocardiosis
Abstract

Chronic bronchoalveolar infection is the persistent impairment of respiratory tract, secondary to infectious pathologies with difficult diagnosis and, therefore, complex treatment. Broad spectrum etiologies are involved and current morbidity and mortality rates are high. Drug-resistant tuberculosis (TB) incidence has increased in last decades and poses a public health threat. Bronchiectasis featured by abnormally dilated bronchi walls accompanied by ciliary epithelium impairment, are also a frequent cause of chronic bronchial infection and inflammation. Treatment protocols look for removing the cause and resolving the infections. Furthermore, immunosuppressed patients are more prone to opportunistic infections, for example mycoses and nocardiosis. Being a group of severe diseases with high mortality rates, early diagnosis and treatment are mandatory. In order to achieve patient healing, treatment not only relies on antifungal drugs but also on improving patient immunocompetence.

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