Aspergilose invasiva: diagnóstico clínico, laboratorial e terapêutica preconizada.

Abstract

Aspergillosis, an infection caused by Aspergillus species, has emerged as a major disease at the level of intensive care units in hospitals, being invasive aspergillosis, the disease that presents higher levels of mortality and morbidity. The genus Aspergillus is distributed world-wide and in several habitats, without geographic preference. A. fumigatus is the etiological agent responsible for approximately 90% of cases of aspergillosis. Aspergillosis comprises a wide spectrum of diseases, in which it can manifest itself in a variety of forms, either through allergic diseases or chronic cavitary forms, or it may manifest itself as an invasive disease. Invasive aspergillosis is considered to be an opportunistic, progressive, acute and severe fungal infection of poor prognosis with a higher risk of life in immunosuppressed patients or who are subjected to extremely aggressive therapies by the use of corticosteroids, antibiotics and immunosuppressive drugs, as well as in cases of prolonged agranulocytosis. Invasive aspergillosis is difficult to diagnose, its symptoms and clinical signs are nonspecific, they appear already in a late stage of the infection, making early diagnosis very important. It is of great importance that the treatment be started as soon as possible, thus generating a better prognosis. Voriconazole is the recommended drug as first-line therapy because it has been shown to have better efficacy and tolerance compared to amphotericin B.