Aspectos clínicos y patogénicos de la infección profunda por trichosporon asahii

Paola Suárez Álvarez, Marta Puello Hoyos, Ketty Mendoza Ballestas

DOI: https://doi.org/10.32997/rcb-2013-2831

Resumen

Introducción: Trichosporon beigelii, por mucho tiempo fue considerado la única especie del género y se le reconocía particularmente por ser el agente causal de una micosis del pelo denominada “piedra blanca”. La taxonomía del género ha cambiado y se han descrito alrededor de trece especies implicadas en enfermedades humanas.
T. inkin, T. cutaneum, T. mucoides, T. asteroides, T. ovoides y T. asahii, son las seis especies que más frecuentemente se han asociado a infección localizada o diseminada.
Objetivo: revisar la información disponible sobre Trichosporon spp. e identificar el impacto que tiene T. asahii como agente patógeno.
Metodología: se realizó búsqueda bibliográfica en Pubmed, reuniendo la información obtenida en el programa para manejo bibliográfico Endnote X1. Se tuvieron en cuenta artículos completos y resúmenes de investigaciones originales y revisiones.
Resultados: el principal agente causal de trichosporonosis profunda es el T. asahii. Esta levadura se ha asociado a infecciones cutáneas y sistémicas. La infección se presenta en estados con compromiso inmunológico: cáncer, enfermedad crónica o alteraciones en las barreras cutáneas y mucosas. En general se considera que las vías de entrada
pueden ser catéteres, tubos de drenaje, discontinuidad de la piel en pacientes quemados o también por traslado desde la mucosa intestinal. Se han descrito seis genotipos de T.asahii, que son de distribución mundial, con predominio del genotipo-1. El proceso de patogénesis de la trichosporonosis está determinado por la condición inmunológica del
paciente y los factores de virulencia del agente. Se han señalado como posibles factores de virulencia la presencia de glucoroxilomano. El diagnóstico se realiza con pruebas metabólicas y moleculares. El tratamiento de la trichosporonosis profunda es poco eficaz si la inmunodeficiencia no se supera. Es creciente la resistencia a Anfotericina-B y otros antifúngicos. Se obtienen mejores resultados con voriconazol.
Conclusión: la trichosporonosis profunda por T. asahii es una entidad micótica emergente que afecta especialmente a pacientes neutropénicos. El diagnóstico es un reto y es elevada la tasa de mortalidad. Rev.cienc.biomed. 2013;4(2):327-334


Palabras clave

Micosis; Trichosporon; Fungemia; Sistema inmunológico; Infecciones oportunistas.

Texto completo:

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