Las infecciones por Aspergillus fumigatus han aumentado debido al incremento del tratamiento con inmunosupresores y a la mayor incidencia de enfermedades pulmonares crónicas. Es fundamental un diagnóstico precoz e instaurar el tratamiento adecuado de la aspergilosis pulmonar invasiva en pacientes con enfermedades pulmonares crónicas. La rehabilitación respiratoria es esencial en estos casos, dada la dificultad para revertir la insuficiencia respiratoria en pacientes con EPOC grave.

---

Bibliografía del caso clínico
Bibliografía
1. O´Gorman CM, Fuller H, Dyer PS. Discovery of a sexual cycle in the opportunistic fungal pathogen Aspergillus fumigatus. Nature 457:471-474, 2009.
2. De Vries RP, Visser J. Aspergillus enzymes involved in degradation of plant cell Wall polysaccharides. Microbiol Mol Biol Rev 65:497-522, 2001.
3. Cadena J, Thompson GR, Patterson TF. Aspergillosis: Epidemiology, Diagnosis and Treatment. Infect Dis Clin Am 35:415-434, 2021.
4. Lumbreras C, Gavaldá J, Aspergilosis invasora: Manifestaciones clínicas y tratamiento. Rev Iberoam Micol 20:79-89, 2003.
5. Romero-Paljmacios A, Mera Gallardo O, Jimenez Aguilar P, Borrallo Morrejón JJ, KMaza Ortega C, Rodriguez-Iglesias MA. Traqueobronquitis obstructiva por Aspergillus fumigatus en un paciente inmunocompetente. Rev Iberoam Mico 36:34-36, 2019.
6. Humphrey JM, Walsh TJ, Sulick RM. Invasive Aspergillus Sinusitis in Human Immunodeficiency Virus Infection. Case Report and Review of the Literature. Open Forum Infect Dis 3: ofw135, 2016.
7. Leroy J, Vuotto F, Le V, et al. Invasive rhino-orbital-cerebral aspergillosis in an immunocompetent patient. J Mycol Med 30(3):101002, 2020.
8. Perman J, Ortiz R, Crespo M, et al. Endocarditis por Aspergillus fumigatus en válvula nativa con hemocultivo positivo y galactomanano negativo. Descripción de un caso y revisión de la literatura. Rev Iberoam Micol 24:157-160, 2007.
9. Gopal K, Bhaskaran PN, Moni M, Shashindran N. Aspergillus endocarditis. Indian Heart J 76(4):240-246, 2024.
10. Spapen H, Spapen J, Taccone F, et al. Cerebral aspergillosis in adult critically ill patients: a descriptive report of 10 patients from the ASPICY cohort. Int J Antimicrob Agents 43(2):165-169, 2014.
11. Bokhari R, Baeesa S, Al-Maghrabi J, Madani T. Isolated cerebral aspergillosis in immunocompetent patients. World Neurosurg 82(1-2):325-333, 2014.
12. Louati I, Zaouali J, Azzouz O, et al. Cerebral aspergillosis in immunocompetent patients: three case reports. Rev Neurol (Paris) 165(11): 957-961, 2009.
13. Ceylan B, Yilmaz M, ffet Beköz HS, et al. Primary gastrointestinal aspergillosis: a case report and literature review. Le Infez Med 27(1):85-92, 2019.
14. Yelika SB, Tumati A, Denoya P. Intestinal Aspergillosis: Systematic review on Patterns of Clinical Presentation and Management. Surg Infect (Larchmt) 22(3):326-333, 2021.
15. Wolfson JS, Sober AJ, Rubin RH. Dermatologic manifestations of infections in immunocompromised patients. Medicine 64:115-133. 1985.
16. Allo MD, Miller J, Towsend T, Tan C. Primary cutaneous aspergillosis associated with Hickman intravenous catheters. N Engl J Med 317:1105-1108, 1987.
17. Koren Fernandez L, Alonso Charterina S, Alcalá-Galiano Rubio A, Sanchez Nistal M. Las diferentes manifestaciones de la aspergilosis pulmonar. Hallazgos en tomografía computarizada multidetector. Radiología 56(6):496-504, 2014.
18. Bulpa P, Dive A, Sibille Y. Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease. Eur Respir J 30:782-800, 2007.
19. Samarakoom O, Soubani AO, Invasive pulmonary aspergillosis in patients with COPD: a report of five cases and systematic review of the literature. Chron Respir Dis 5:19-27, 2008.
20. Lin SJ, Schranz J, Teutsch SM. Aspergillosis case-fatality rate: systematic review of the literature. Clin Infect Dis 32:358-366, 2001.
21. Ramirez P. Garnacho-Montero J. Aspergilosis invasiva en el paciente crítico. Rev Iberoam Micol 35:210-216, 2018.
22. Läss-Flörl C, Resch G, Nachbaur D, et al. The value of computed tomography-guided percutaneous lung biopsy for diagnosis of invasive fungal infection in immunocompromised patients. Clin Infect Dis 45:e101-e104, 2007.
23. Schelenz S, Barnes RA, Barton RC, et al. British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal disease. Lancet Infect Dis 15:461-474, 2015.
24. Koehler P, Bassetti M, Chakrabarti A, et al. Defining and managing COVID-19- associated pulmonary aspergillosis: the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance. Lancet Infect Dis 21:e49-e162, 2020.
25. Mercier T, Castagnola E, Marr K, Wheat J, Verweij P, Maertens JA. Defining galactomannan positivy in the update EORTC/MSGERC consensus definition of invasive fungal diseases. Clin Infect Dis 72:S89-S94, 2021.
26. Barberán J, Mensa J. Aspergilosis pulmonar invasiva en el enfermo con enfermedad pulmonar obstructiva crónica. Rev Iberoam Micol 31(4):237-241, 2014.
27. Patterson TF, Thompson III GR, Denning DW, et al. Practice Guidelines for the Diagnosis and Management of Aspergillosis. 2016. Update by the Infectious Diseases Society of America. Clin Infect Dis 63:e1-e60, 2016.
28. Douglas AP, Smibert OC, Ashish B, et al. Consensus guidelines for the diagnosis and management of invasive aspergillosis. Intern Med J 51 (Suppl 7):143-176, 2021.

Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.