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Aspergilosis invasiva de la base del cráneo en un paciente en diálisis peritoneal: una complicación rara y

Nattapakorn Mai-On¹, Rubash Nath Yogi², Piyaporn Towangnang³

¹Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Medical mycology case reports

|January 16, 2026

Resumen

Este reporte de caso detalla una rara infección invasiva por Aspergillus flavus de la mastoides y la base del cráneo en un paciente en diálisis peritoneal (DP). La intervención temprana fue insuficiente, lo que resalta la necesidad de un diagnóstico y manejo rápidos de esta grave infección fúngica.

Área de la Ciencia:

Enfermedades Infecciosas
Micología
Neurocirugía

Sus antecedentes:

La aspergilosis invasiva de la mastoides y la base del cráneo es rara, particularmente en pacientes en diálisis peritoneal (DP).
Las infecciones fúngicas en pacientes en DP pueden provocar complicaciones graves y potencialmente mortales.

Objetivo del estudio:

Presentar el primer caso documentado de mastoiditis invasiva por Aspergillus flavus con osteomielitis de la base del cráneo en un paciente en DP.
Enfatizar los desafíos en el manejo de esta infección agresiva y la importancia del diagnóstico temprano y la atención multidisciplinaria.

Principales métodos:

Un paciente masculino de 60 años en DP con insuficiencia renal diabética presentó síntomas de mastoiditis.
Los procedimientos de diagnóstico incluyeron secuenciación molecular para la identificación fúngica.
El tratamiento incluyó mastoidectomía, remoción del catéter de DP y terapia con voriconazol.

Principales resultados:

El paciente desarrolló mastoiditis invasiva por Aspergillus flavus que progresó a osteomielitis de la base del cráneo, involucrando la vaina carotídea y el espacio parafaríngeo.
A pesar del tratamiento, ocurrieron graves complicaciones neurológicas y sistémicas.
La secuenciación molecular confirmó Aspergillus flavus, descartando especies crípticas.

Conclusiones:

Este caso resalta el potencial de la aspergilosis invasiva para progresar rápidamente en pacientes en DP.
La sospecha temprana, la confirmación molecular a nivel de especie y el manejo agresivo multidisciplinario son cruciales para combatir esta formidable infección.

Palabras clave:

Aspergillus flavus Mastoiditis por Aspergillus Identificación molecular Diálisis peritoneal Osteomielitis de la base del cráneo Voriconazol

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