Aspergilosis invasora post-quirúrgica Presentación de caso clínico
Álvaro Rodríguez Vega1 Margarita Sánchez Chacón1 Rodrigo Casals Aguirre2 Mirta Acuña Avila3
1.- Internos de Medicina, Universidad de Chile
Departamento de Cirugía Infantil, Hospital de Niños Roberto del Rio
3.- Departamento de Infectología, Hospital de Niños Roberto del Rio
INVASIVE ASPERGILLOSIS POST SURGICAL PRESENTATION OF CASE
Invasive aspergillosis is an opportunistic infection caused by fungi of the genus Aspergillus spp, considered the worst prognosis produced by this organism. It has a high mortality despite progress in antifungal treatments, affecting mainly immunocompromised patients. Clinically can occur following surgery , leading to high morbidity and mortality.
We report a case of Roberto Del Río Hospital. Term newborn diagnosed with transposition of the great vessels, who at 9 days of life undergoes corrective surgery. Leaves the pavilion with open chest and requirement of vasoactive drugs. On the tenth day after surgery presents hemodynamic deterioration, the echocardiogram shows refringence and surgical cleaning is performed, a sample is removed and cultured resulting positive for Aspergillus terreus. Therefore, treatment with voriconazole starts with good clinical response.
Cardiac surgery is the leading cause of post-surgical invasive aspergillosis. The origin is the contamination of the surgical procedure through Aspergillus spp spores in the air. As for antifungal therapy the use of voriconazole is recommended as first-line treatment but the and duration of this has not been complete defined based on the evidence.
In relation to prevention,it is recommended surgical procedure pavilions ventilation filtration system HEPA (High Efficiency Particle Arrestance) and appropriate sterile technique during the intervention.