Micosis pulmonares en pacientes de la Quinta Región. Periodo 2007-2010.

Resumen

FREQUENCY OF PULMONARY MYCOSES DETERMINED BY ANALYZING LUNG SECRETION SAMPLES

Background: The frequency of pulmonary mycoses  has increased in the past few years specially in immunocompromised patients. Aim: To determine the  frequency of invasive fungal diseases by  analyzing  lung secretion samples. Material and Methods: Samples of  bronchoalveolar lavage (BAL) tracheal aspiration (TA) and induced sputum (IS) were obtained from patients of  five hospitals in the Valparaíso Region for the diagnosis of invasive or non-invasive fungal disease, and pneumocystis (PCP), in the period 2007- 2010. Clinical data of patients was obtained reviewing medical records or interviewing attending physicians. The diagnosis considered the clinical condition of the patient  (immunocompromised  or prior lung damage), computed tomography  imaging, direct microscopy and cultures. European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria  was used for the diagnosis of invasive fungal diseases. Results: Ninety respiratory samples were received and 39 fungal infections were diagnosed. Eleven were probably invasive, seven were non-invasive and 21 were PCP. All patients with probable invasive disease had neutropenia. Most patients with non-invasive infections had bronchiectasis. Aspergillus fumigatus was the main  causing agent  in both invasive and non-invasive fungal diseases. Patients with  PCP were mostly adults with AIDS and children with leukemia. The total mortality rate of patients with invasive fungal disease  was of 73%. No deaths were recorded among patients with  non-invasive disease. Among patients with PCT, three of 11 HIV  and six of 10 non HIV subjects died.  Conclusions: Aspergillus fumigatus  predominates both in invasive and non-invasive pulmonary mycoses. The former  has a high mortality. PCP occurred mainly in adult patients with HIV-AIDS.