Imagen clínica
Un caso de aspergilosis angioinvasiva
A Case of Angioinvasive Aspergillosis
Read
6644
Timeswas read the article
2014
Total PDF
4630
Total HTML
Share statistics
array:24 [ "pii" => "S0300289616302587" "issn" => "03002896" "doi" => "10.1016/j.arbres.2016.09.013" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "1475" "copyright" => "SEPAR" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2017;53:273" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2244 "formatos" => array:3 [ "EPUB" => 117 "HTML" => 1569 "PDF" => 558 ] ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S1579212916303226" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.11.024" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "1475" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2017;53:273" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1458 "formatos" => array:3 [ "EPUB" => 139 "HTML" => 1038 "PDF" => 281 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "A Case of Angioinvasive Aspergillosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "273" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Un caso de aspergilosis angioinvasiva" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 642 "Ancho" => 1500 "Tamanyo" => 116648 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Initial CT scan (left image) showing ill-defined nodules (arrow) with upper lobe predominance. Follow-up CT scan (right image) performed 3 weeks after starting treatment showing cavitation of known nodules.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Víctor Vázquez Sánchez, Armando Gózalo García, Fermín Sáez Garmendia" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Víctor" "apellidos" => "Vázquez Sánchez" ] 1 => array:2 [ "nombre" => "Armando" "apellidos" => "Gózalo García" ] 2 => array:2 [ "nombre" => "Fermín" "apellidos" => "Sáez Garmendia" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616302587" "doi" => "10.1016/j.arbres.2016.09.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302587?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916303226?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000005/v1_201704280925/S1579212916303226/v1_201704280925/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0300289616302721" "issn" => "03002896" "doi" => "10.1016/j.arbres.2016.09.016" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "1489" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:274-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3644 "formatos" => array:3 [ "EPUB" => 133 "HTML" => 2882 "PDF" => 629 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Empiema por <span class="elsevierStyleItalic">Actinomyces meyeri</span>" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "274" "paginaFinal" => "276" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "<span class="elsevierStyleItalic">Actinomyces Meyeri</span> Empyema" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Lucía Ferreiro, María Luisa Pérez del Molino, Carlos Rábade, Luis Valdés" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Lucía" "apellidos" => "Ferreiro" ] 1 => array:2 [ "nombre" => "María Luisa" "apellidos" => "Pérez del Molino" ] 2 => array:2 [ "nombre" => "Carlos" "apellidos" => "Rábade" ] 3 => array:2 [ "nombre" => "Luis" "apellidos" => "Valdés" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212917300927" "doi" => "10.1016/j.arbr.2017.03.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917300927?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302721?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000005/v1_201704280943/S0300289616302721/v1_201704280943/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0300289616302708" "issn" => "03002896" "doi" => "10.1016/j.arbres.2016.11.001" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "1487" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2017;53:272" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2029 "formatos" => array:3 [ "EPUB" => 104 "HTML" => 1467 "PDF" => 458 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen clínica</span>" "titulo" => "Aspiración de cuerpo extraño en relación con la aplicación de broncodilatador inhalado" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "272" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Foreign body aspiration during inhaled bronchodilator administration" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1001 "Ancho" => 2461 "Tamanyo" => 254426 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Radiografía de tórax posteroanterior y lateral, en la que se visualiza cuerpo extraño (bombilla) alojado en el bronquio principal derecho.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Teresa Gómez Hernández, Nuria M. Novoa, Marcelo F. Jiménez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M. Teresa" "apellidos" => "Gómez Hernández" ] 1 => array:2 [ "nombre" => "Nuria M." "apellidos" => "Novoa" ] 2 => array:2 [ "nombre" => "Marcelo F." "apellidos" => "Jiménez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212917300903" "doi" => "10.1016/j.arbr.2017.03.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917300903?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302708?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000005/v1_201704280943/S0300289616302708/v1_201704280943/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen clínica</span>" "titulo" => "Un caso de aspergilosis angioinvasiva" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "273" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Víctor Vázquez Sánchez, Armando Gozalo García, Fermín Sáez Garmendia" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Víctor" "apellidos" => "Vázquez Sánchez" "email" => array:1 [ 0 => "victor_becedillas@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Armando" "apellidos" => "Gozalo García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Fermín" "apellidos" => "Sáez Garmendia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Tenerife, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Sección de Radiología Pediátrica, Hospital de Cruces, Barakaldo, Vizcaya, España" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "A Case of Angioinvasive Aspergillosis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 596 "Ancho" => 1400 "Tamanyo" => 112026 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) La TC inicial muestra nódulos con bordes mal definidos (flecha) predominantes en ambos lóbulos superiores. B) La TC de seguimiento, practicada 3 semanas después de iniciarse el tratamiento muestra cavitación de los nódulos previamente observados.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mujer de 13 años con episodio de neutropenia febril en el contexto de una aplasia medular secundaria a quimioterapia por leucemia linfocítica aguda. Ante la sospecha de infección oportunista, se practicó la prueba del galactomanano, cuyo resultado fue positivo.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Se realizó una TC ante la posible afectación pulmonar. La exploración reveló la presencia de numerosos nódulos pulmonares sólidos de distribución bilateral y predominio en ambos lóbulos superiores. Dichos nódulos presentaban bordes mal definidos y un área adyacente de atenuación en vidrio deslustrado («signo del halo») (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>A). En este contexto clínico los hallazgos corresponden a infartos hemorrágicos y son muy indicativos de aspergilosis angioinvasiva. No obstante, en otras enfermedades mucho menos frecuentes, tales como mucormicosis y candidiasis, herpes simple y citomegalovirus, granulomatosis de Wegener, sarcoma de Kaposi o metástasis hemorrágicas es posible observar hallazgos similares en la TC<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Se inició tratamiento antifúngico para la aspergilosis con evolución clínica favorable. Tres semanas después de iniciarse el tratamiento se efectuó una TC de seguimiento, que mostró cavitación de múltiples nódulos con persistencia de escaso componente sólido en el interior de los mismos. Este signo se conoce como el «signo del menisco» (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>B) y está presente en un 50% de los casos<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>. Representa la separación entre el parénquima necrótico y el sano, y cuando se observa después del «signo del halo», reafirma el diagnóstico de aspergilosis<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 596 "Ancho" => 1400 "Tamanyo" => 112026 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) La TC inicial muestra nódulos con bordes mal definidos (flecha) predominantes en ambos lóbulos superiores. B) La TC de seguimiento, practicada 3 semanas después de iniciarse el tratamiento muestra cavitación de los nódulos previamente observados.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spectrum of pulmonary aspergillosis: Histologic, clinical, and radiologic findings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Franquet" 1 => "N.L. Müller" 2 => "A. Giménez" 3 => "P. Guembe" 4 => "J. de La Torre" 5 => "S. Bagué" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiographics.21.4.g01jl03825" "Revista" => array:7 [ "tituloSerie" => "Radiographics" "fecha" => "2001" "volumen" => "21" "paginaInicial" => "825" "paginaFinal" => "837" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11452056" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0025775314005533" "estado" => "S300" "issn" => "00257753" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary Aspergillosis: What CT can Offer Before it is too Late!" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Prasad" 1 => "K. Agarwal" 2 => "D. Deepak" 3 => "S.S. Atwal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7860/JCDR/2016/21443.8210" "Revista" => array:7 [ "tituloSerie" => "J Clin Diagn Res" "fecha" => "2016" "volumen" => "10" "paginaInicial" => "TE01" "paginaFinal" => "TE05" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27630924" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0213911112001598" "estado" => "S300" "issn" => "02139111" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005300000005/v1_201704280943/S0300289616302587/v1_201704280943/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005300000005/v1_201704280943/S0300289616302587/v1_201704280943/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302587?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 2 | 5 |
| 2024 October | 89 | 18 | 107 |
| 2024 September | 74 | 13 | 87 |
| 2024 August | 73 | 29 | 102 |
| 2024 July | 55 | 23 | 78 |
| 2024 June | 75 | 23 | 98 |
| 2024 May | 81 | 23 | 104 |
| 2024 April | 60 | 25 | 85 |
| 2024 March | 65 | 20 | 85 |
| 2024 February | 39 | 22 | 61 |
| 2023 March | 19 | 4 | 23 |
| 2023 February | 74 | 29 | 103 |
| 2023 January | 64 | 26 | 90 |
| 2022 December | 78 | 28 | 106 |
| 2022 November | 102 | 39 | 141 |
| 2022 October | 117 | 39 | 156 |
| 2022 September | 69 | 25 | 94 |
| 2022 August | 68 | 39 | 107 |
| 2022 July | 48 | 44 | 92 |
| 2022 June | 48 | 26 | 74 |
| 2022 May | 50 | 38 | 88 |
| 2022 April | 47 | 44 | 91 |
| 2022 March | 75 | 40 | 115 |
| 2022 February | 49 | 24 | 73 |
| 2022 January | 70 | 32 | 102 |
| 2021 December | 46 | 46 | 92 |
| 2021 November | 61 | 46 | 107 |
| 2021 October | 84 | 49 | 133 |
| 2021 September | 56 | 46 | 102 |
| 2021 August | 59 | 45 | 104 |
| 2021 July | 53 | 48 | 101 |
| 2021 June | 72 | 54 | 126 |
| 2021 May | 75 | 43 | 118 |
| 2021 April | 179 | 92 | 271 |
| 2021 March | 107 | 42 | 149 |
| 2021 February | 67 | 26 | 93 |
| 2021 January | 58 | 25 | 83 |
| 2020 December | 55 | 24 | 79 |
| 2020 November | 51 | 29 | 80 |
| 2020 October | 50 | 28 | 78 |
| 2020 September | 62 | 20 | 82 |
| 2020 August | 46 | 21 | 67 |
| 2020 July | 50 | 26 | 76 |
| 2020 June | 62 | 17 | 79 |
| 2020 May | 64 | 17 | 81 |
| 2020 April | 38 | 16 | 54 |
| 2020 March | 56 | 15 | 71 |
| 2020 February | 56 | 14 | 70 |
| 2020 January | 66 | 16 | 82 |
| 2019 December | 73 | 32 | 105 |
| 2019 November | 47 | 23 | 70 |
| 2019 October | 36 | 13 | 49 |
| 2019 September | 40 | 10 | 50 |
| 2019 August | 164 | 16 | 180 |
| 2019 July | 38 | 22 | 60 |
| 2019 June | 37 | 13 | 50 |
| 2019 May | 57 | 24 | 81 |
| 2019 April | 49 | 32 | 81 |
| 2019 March | 49 | 23 | 72 |
| 2019 February | 36 | 30 | 66 |
| 2019 January | 56 | 13 | 69 |
| 2018 December | 34 | 18 | 52 |
| 2018 November | 90 | 42 | 132 |
| 2018 October | 96 | 23 | 119 |
| 2018 September | 50 | 7 | 57 |
| 2018 August | 3 | 0 | 3 |
| 2018 June | 2 | 0 | 2 |
| 2018 May | 27 | 2 | 29 |
| 2018 April | 47 | 4 | 51 |
| 2018 March | 48 | 10 | 58 |
| 2018 February | 53 | 10 | 63 |
| 2018 January | 75 | 19 | 94 |
| 2017 December | 54 | 11 | 65 |
| 2017 November | 28 | 26 | 54 |
| 2017 October | 41 | 20 | 61 |
| 2017 September | 46 | 33 | 79 |
| 2017 August | 53 | 23 | 76 |
| 2017 July | 2 | 2 | 4 |
| 2017 June | 3 | 3 | 6 |
| 2017 May | 30 | 22 | 52 |
| 2017 April | 1 | 3 | 4 |
| 2017 March | 0 | 1 | 1 |
| 2017 February | 0 | 3 | 3 |
| 2017 January | 0 | 1 | 1 |
Show all
