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Histoplasmosis diseminada en un paciente con infección por VIH no tratada durante 23 años
1Family Medicine, University of Mississippi Medical Center, Jackson, USA.
Cureus
|February 10, 2026
Resumen
La histoplasmosis diseminada es un riesgo grave para las personas con el virus de la inmunodeficiencia humana (VIH) avanzado y no tratado. El diagnóstico precoz y la atención constante son cruciales para prevenir y controlar esta infección oportunista en pacientes inmunocomprometidos.
Área de la Ciencia:
- La micología de la micología.
- Enfermedades infecciosas Enfermedades infecciosas.
- Inmunología Inmunología.
Sus antecedentes:
- La histoplasmosis es una infección oportunista grave en casos avanzados de virus de la inmunodeficiencia humana (VIH), especialmente en áreas endémicas.
- El diagnóstico tardío y la adherencia al tratamiento en el VIH no tratado contribuyen a las infecciones oportunistas graves.
- Los avances en la terapia antirretroviral no han eliminado los riesgos para las personas con diagnóstico y atención tardías del VIH.
Objetivo del estudio:
- Para presentar un caso de histoplasmosis diseminada en un paciente con una larga historia de VIH no tratado.
- Para resaltar el vínculo entre el VIH no tratado prolongado, la inmunosupresión severa y las infecciones oportunistas.
- Hacer hincapié en el impacto de las barreras a la atención en la gravedad de la enfermedad y el diagnóstico.
Principales métodos:
- Informe de caso de una mujer de 43 años con 23 años de VIH sin tratamiento.
- Evaluación de laboratorio que incluye carga viral, recuento de CD4, electrolitos y transaminasas hepáticas.
- Tomografía computarizada (TC) y biopsia de ganglios linfáticos retroperitoneal para el diagnóstico.
Principales resultados:
- El paciente presentó síntomas de fiebre, pérdida de peso, diarrea y malestar.
- Se observó una inmunosupresión grave (número de CD4 de 8 células / μL) con una alta carga viral.
- La biopsia de ganglios linfáticos confirmó la histoplasmosis diseminada; el tratamiento condujo a una mejoría clínica.
Conclusiones:
- El VIH no tratado durante mucho tiempo conduce a una inmunosupresión avanzada y un mayor riesgo de histoplasmosis diseminada.
- El estigma y las barreras de acceso a la atención médica contribuyen al diagnóstico tardío y a las infecciones oportunistas graves.
- El diagnóstico temprano del VIH, la vinculación de la atención y la participación del paciente son vitales para prevenir las infecciones oportunistas graves.
Palabras clave:
SIDA complicaciones complicacionesNo adherencia antirretroviral no adherencia antirretroviralLas granulomas de casado son granulomas de casado.diseminación de la histoplasmosis diseminada.El VIH es una enfermedad avanzada.La inmunosupresión es la inmunosupresión.Infección por hongos oportunistas.La linfadenopatía retroperitoneal es una linfadenopatía retroperitoneal.Severo agotamiento del CD4.El estigma y la atención del VIH.Más Videos Relacionados
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