{"id":31372,"date":"2015-01-10T19:25:38","date_gmt":"2015-01-10T18:25:38","guid":{"rendered":"http:\/\/www.revista-portalesmedicos.com\/revista-medica\/?p=31372"},"modified":"2015-01-10T19:25:39","modified_gmt":"2015-01-10T18:25:39","slug":"aneurisma-micotico","status":"publish","type":"post","link":"https:\/\/www.revista-portalesmedicos.com\/revista-medica\/aneurisma-micotico\/","title":{"rendered":"Aneurisma mic\u00f3tico"},"content":{"rendered":"<h3 style=\"text-align: left;\"><strong>Aneurisma mic\u00f3tico<\/strong><\/h3>\n<p style=\"text-align: justify;\">Presentamos el caso cl\u00ednico de un paciente de 74 a\u00f1os con un aneurisma mic\u00f3tico. Creemos que es interesante por la escasa prevalencia de esta entidad nosol\u00f3gica y por la comparaci\u00f3n de las im\u00e1genes del aneurisma con y sin infecci\u00f3n.<\/p>\n<p style=\"text-align: justify;\"><!--more--><\/p>\n<p style=\"text-align: justify;\"><strong>Aneurisma mic\u00f3tico<\/strong><\/p>\n<p style=\"text-align: justify;\">Autores:<\/p>\n<p style=\"text-align: justify;\">Joaqu\u00edn Sol\u00eds, M\u00e9dico especialista en Geriatr\u00eda. Servicio de Geriatr\u00eda. Hospital Sanitas la Moraleja. Madrid. Espa\u00f1a<\/p>\n<p style=\"text-align: justify;\">Manuel Montes Lluch, M\u00e9dico especialista en Geriatr\u00eda. Servicio de Geriatr\u00eda. Hospital Sanitas la Moraleja. Madrid. Espa\u00f1a<\/p>\n<p style=\"text-align: justify;\">Mar\u00eda Eugenia Garc\u00eda Ram\u00edrez. M\u00e9dico especialista en Geriatr\u00eda. Servicio de Geriatr\u00eda. Hospital Sanitas la Moraleja. Madrid. Espa\u00f1a<\/p>\n<p style=\"text-align: justify;\">Carlos de la Fuente Guti\u00e9rrez. M\u00e9dico especialista en Geriatr\u00eda. Jefe del Servicio de Geriatr\u00eda. Hospital Sanitas la Moraleja. Madrid. Espa\u00f1a<\/p>\n<p style=\"text-align: justify;\">Palabras Clave: aneurisma, infecci\u00f3n bacteriana, mic\u00f3tico<\/p>\n<p style=\"text-align: justify;\">Var\u00f3n de 74 a\u00f1os, con antecedentes de diabetes mellitus tipo 2, arteriopat\u00eda perif\u00e9rica, hipertensi\u00f3n arteril, hipercolesterolemia, s\u00edndrome de apnea del sue\u00f1o, cardiopat\u00eda isqu\u00e9mica, disfunci\u00f3n sist\u00f3lica, que en preoperatorio de revascularizaci\u00f3n coronaria con triple by-pass se diagnostica aneurisma abdominal de 88 x 98 mm de di\u00e1metro (Figura 1, flecha). \u00a0Una vez realizada la intervenci\u00f3n coronaria, se procede a by-pass axilo bifemoral en espera de reparaci\u00f3n aneurism\u00e1tica definitiva en 2\u00ba tiempo.<\/p>\n<p style=\"text-align: justify;\">A las tres \u00a0semanas comienza con fiebre y dolor abdominal, repiti\u00e9ndose el TAC (figura 2)\u00a0 donde se observa el aneurisma ya conocido con trombosis exc\u00e9ntrica prominente, y m\u00faltiples im\u00e1genes de densidad aire en el interior del vaso, murales y perianeurism\u00e1ticas retroperitoneales extendi\u00e9ndose hacia compartimento de ambos psoas (flechas). En los hemocultivos crece Escherichia coli sensible a meropenem. Se desestima la \u00a0cirug\u00eda aneurism\u00e1tica por el alto riesgo quir\u00fargico inici\u00e1ndose tratamiento m\u00e9dico con pobre respuesta, falleciendo a las 4 semanas por shock s\u00e9ptico.<\/p>\n<p style=\"text-align: justify;\">El aneurisma mic\u00f3tico es una entidad cl\u00ednica poco prevalente, habitualmente causada por cocos\u00a0 Gram positivos, con elevada mortalidad, a\u00fan mayor si no se trata quir\u00fargicamente. En este caso el \u00fanico germen evidenciado en los hemocultivos fue Escherichia coli, si bien es probable que dados los datos radiol\u00f3gicos existiesen otras bacterias, anaerobias, que contribuyesen a la infecci\u00f3n.<\/p>\n<figure id=\"attachment_31373\" aria-describedby=\"caption-attachment-31373\" style=\"width: 390px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/www.revista-portalesmedicos.com\/revista-medica\/wp-content\/uploads\/1-TAC-aneurisma-abdominal.jpg\"><img decoding=\"async\" class=\"size-full wp-image-31373\" src=\"http:\/\/www.revista-portalesmedicos.com\/revista-medica\/wp-content\/uploads\/1-TAC-aneurisma-abdominal.jpg\" alt=\"TAC-aneurisma-abdominal\" width=\"400\" height=\"282\" srcset=\"https:\/\/www.revista-portalesmedicos.com\/revista-medica\/wp-content\/uploads\/1-TAC-aneurisma-abdominal.jpg 400w, https:\/\/www.revista-portalesmedicos.com\/revista-medica\/wp-content\/uploads\/1-TAC-aneurisma-abdominal-300x212.jpg 300w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/a><figcaption id=\"caption-attachment-31373\" class=\"wp-caption-text\">TAC. Aneurisma abdominal<\/figcaption><\/figure>\n<p style=\"text-align: justify;\">Figura 1<\/p>\n<figure id=\"attachment_31374\" aria-describedby=\"caption-attachment-31374\" style=\"width: 390px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/www.revista-portalesmedicos.com\/revista-medica\/wp-content\/uploads\/2-aneurisma-micotico-TAC.jpg\"><img decoding=\"async\" class=\"size-full wp-image-31374\" src=\"http:\/\/www.revista-portalesmedicos.com\/revista-medica\/wp-content\/uploads\/2-aneurisma-micotico-TAC.jpg\" alt=\"aneurisma-micotico-TAC\" width=\"400\" height=\"308\" srcset=\"https:\/\/www.revista-portalesmedicos.com\/revista-medica\/wp-content\/uploads\/2-aneurisma-micotico-TAC.jpg 400w, https:\/\/www.revista-portalesmedicos.com\/revista-medica\/wp-content\/uploads\/2-aneurisma-micotico-TAC-300x231.jpg 300w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/a><figcaption id=\"caption-attachment-31374\" class=\"wp-caption-text\">Aneurisma mic\u00f3tico. TAC<\/figcaption><\/figure>\n<p style=\"text-align: justify;\">Figura 2<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Aneurisma mic\u00f3tico Presentamos el caso cl\u00ednico de un paciente de 74 a\u00f1os con un aneurisma mic\u00f3tico. Creemos que es interesante por la escasa prevalencia de esta entidad nosol\u00f3gica y por la comparaci\u00f3n de las im\u00e1genes del aneurisma con y sin infecci\u00f3n.<\/p>\n","protected":false},"author":2,"featured_media":31374,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[38],"tags":[2378,5327,2473],"class_list":["post-31372","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-angiologia-cirugia-vascular","tag-aneurisma","tag-infeccion-bacteriana","tag-micotico","no-featured-image-padding"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Aneurisma mic\u00f3tico<\/title>\n<meta name=\"description\" content=\"Aneurisma mic\u00f3tico Presentamos el caso cl\u00ednico de un paciente de 74 a\u00f1os con un aneurisma mic\u00f3tico. 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