Colonización por hongos ambientales en el paciente alérgico respiratorio no controlado

Mercedes Jmenez Matinez, Omar Herrera Barrios, Jose Severino Rodriguez Canosa, Ileana Paneque Rodríguez

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Resumen

Introducción: La presencia de hongos en las vías respiratorias puede provocar en personas susceptibles diversas manifestaciones alérgicas.
Objetivos: Determinar si las especies fúngicas aisladas de la mucosa nasal de pacientes alérgicos respiratorios pueden ser definidas como alergenos sensibilizantes a través de las pruebas cutáneas
Métodos: Estudio observacional, prospectivo y de corte transversal, donde el universo estuvo constituido por todos los pacientes con diagnóstico de alergia respiratoria o inicio de asma bronquial variable descompensada, mayores de 2 años y menores de19, que se asistieron en las consultas de alergia en La Habana, desde enero 2016 a enero 2017. La muestra obtenida fue de 80 pacientes alérgicos respiratorios.
Resultados: Del total de pacientes con clínica de asma, rinitis o ambas, se obtuvieron pruebas cutáneas por el test de Prick positivas a hongos en 52 de ellos (65 %) con una polisensibilización en 24 para 46,1 %. La reactividad cruzada de mayor relevancia se produjo con los alérgenos de Aspergillus, Penicillium y Alternaria. El cultivo resultó positivo en 54 muestras nasales (67 %). El género de hongos predominante en los pacientes alérgicos fue el Aspergillus en 70,3 % y dentro de este el Aspergillus fumigatus en 52,6 %.
Conclusiones: El estudio de la micobiota nasal es una prueba que debe interpretarse junto con las pruebas cutáneas para el diagnóstico de enfermedades alérgicas por hongos ambientales y tener en cuenta su importancia para el control epidemiológico en la exposición a hongos.

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