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2009, Número 4

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Acta Med 2009; 7 (4)


Choque séptico en un paciente con parvovirus B-19 ¿Agente etiológico o infección oportunista?

Rojo EA, Orzechowski RA, Videgaray OF

Idioma: Español
Referencias bibliográficas: 35
Paginas: 205-209
Archivo PDF: 196.29 Kb.


RESUMEN

El parvovirus humano B19 es un virus ADN, agente causal de la enfermedad infantil llamada eritema infeccioso. En adultos se presenta como una enfermedad autolimitada, con fiebre, artralgias, erupción cutánea, fatiga y edema. En los pacientes inmunocomprometidos puede producir anemia crónica. Se han reportado casos aislados de infecciones graves por parvovirus B19 como miocarditis, vasculitis, linfadenitis, púrpura trombocitopénica autoinmune, síndrome hemofagocítico, hepatitis fulminante, pericarditis, neumonía, anemia aplásica, insuficiencia renal aguda, crisis convulsivas y un caso de sepsis severa. La detección de anticuerpos es el sistema habitual para el diagnóstico de la infección reciente, también se puede demostrar la presencia del virus por microscopia electrónica, detección antigénica y detección de ADN del virus. El tratamiento es sintomático, con antiinflamatorios no esteroideos. El tratamiento de la infección persistente en los pacientes inmunodeprimidos es con inmunoglobulina intravenosa. Presentamos el caso de un adulto sano, con infección por parvovirus B19, que presentó infiltrado pulmonar y en las siguientes 12 horas evolucionó a choque séptico. Se realizó un estudio exhaustivo para encontrar el agente etiológico y sólo fueron positivas la serología y la PCR para parvovirus B19.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Cossart YE, Field AM, Cant B, Widdows D. Parvovirus-like particles in human sera. Lancet 1975; 1: 72-3.

  2. Anderson MJ, Higgins PG, Davis LR et al. Experimental parvoviral infection in humans. J Infect Dis 1985; 152: 257-265.

  3. Anderson M, Jones S, Fisher-Hoch S et al. Human Parvovirus, the cause of erythema infectiosum (fifth disease)? Lancet 1983; 1: 1378.

  4. Aktepe O, Yetgin S, Olcay L, Ozbek. Human parvovirus B19 associated with idiopathic thrombocytopenic purpura. N Pediatr Hematol Oncol 2004; 21: 421-426.

  5. Shirono K, Tsuda H. Parvovirus B19-associated haemophagocytic syndrome in healthy adults. J Haematol 1995; 89: 929-936.

  6. Gratacós E, Torres P, Vidal J, Antolín E, Costa J, Jiménez de Anta M et al. The incidence of human parvovirus B19 infection during pregnancy and its impact on perinatal outcome. J Infect Dis 1995; 171: 1360-1363.

  7. Yaegashi N, Niinuma T, Chisaka H, Watanabe T, Uehara S, Okamura K et al. The incidence of and factors leading to parvovirus B19 related hydrops fetalis following maternal infection; report of 10 cases and meta-analysis. J Infect 1998; 37: 28-35.

  8. Benenson A, Chin J et al. Control of communicable diseases manual. 16.ª ed. Washington: American Public Health Association 1995: 172-174.

  9. Cassinotti P, Siegl G. Quantitative evidence for persistence of human parvovirus B19 DNA in an immunocompetent individual. Eur J Clin Microbiol Infect Dis 2000; 19: 866-867.

  10. Cubel RCN, Oliveira SA, Brown DWG, Cohen BJ, Nascimento JP. Diagnosis of parvovirus B19 infection by detection of specific immunoglobulin M antibody in saliva. J Clin Microbiol 1996; 34: 205-207.

  11. Alvarez R, Fernández B, Jover J, Judez E et al. Human parvovirus B19, varicella zoster virus and human herpes virus 6 in temporal artery biopsy specimens of patients with giant cell arteritis: Analysis with quantitative real time polymerase chain reaction. Rheum Dis 2005; 64: 780-782.

  12. Young N, Brown K. Parvovirus B19. N Engl J Med 2004; 350: 586-597.

  13. Brown KMD. Parvovirus infections. In: Fauci AS, Braunwald E, Kasper DL et al. Principles of internal medicine. 17ª Edition: McGraw-Hill Publishing Co. 2008: 1114-1117, United States of America.

  14. Kühl U, Pauschinger B, Seeberg D, Lassner et al. Viral persistence in the myocardium is associated with progressive cardiac dysfunction. Circulation 2005; 112: 1965-1970.

  15. Jonetzko P, Graziadei I, Nachbaur K, Vogel W et al. Fatal course of parvovirus B19-associated myocarditis in a female liver transplant recipient. Liver Transpl 2005; 11: 463-466.

  16. Finkel T, Torok T, Ferguson P, Durigon E, Zaki S et al. Chronic parvovirus B19 infection and systemic necrotizing vasculitis: opportunistic infection or aetiological agent? Lancet 1994; 343: 1255-8.

  17. Dellinger RP, Levy M, Carlet JM, Bion J, Parker M, Jaeschta R et al. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock. Crit Care Med 2008; 36: 296-327.

  18. Sands K, Bates D, Lanken P et al. Epidemiology of sepsis syndrome in 8 academic medical centers. Academic Medical Center Consortium Sepsis Project Working Group. JAMA 1997; 278: 234–40.

  19. ACCP: American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 1992; 20: 864–74.

  20. Angus DC, Wax RS. Epidemiology of sepsis: an update. Crit Care Med 2001; 29(7 Suppl): S109–16.

  21. Istúriz RE, Torres J, Besso J. Global distribution of infectious diseases requiring intensive care. Crit Care Clin 2006; 22: 469.

  22. Pamuk O, Pamuk G, Celik A, Ozturk R, Aktuglu Y. Herpes simplex virus esophagitis in an immunocompetent host with sepsis. Am J Gastroenterol 2001; 96: 2264–6.

  23. Muhe L, Tilahun M, Lulseged S et al. Etiology of pneumonia, sepsis and meningitis in infants younger than three months of age in Ethiopia. Pediat Infect Dis J 1999; 18(10 Suppl): S56–61.

  24. Gatchalian SR, Quiambao BP, Morelos AM et al. Bacterial and viral etiology of serious infections in very young Filipino infants. Pediat Inf Dis J 1999; 18(10 Suppl): S50–5.

  25. Wenzel R, Pinsky M, Ulevitch R, Young L. Current understanding of sepsis. Clin Infect Dis 1996; 22: 407–12.

  26. Anderson L. Role of parvovirus B19 in human disease. Pediatr Infect Dis J 1987; 6: 711–8.

  27. Hayakawa H, Tara M, Niina K, Osame M. A clinical study of adult human parvovirus B19 infection. Intern Med 2002; 41: 295–9.

  28. Torok T. Unusual clinical manifestations reported in patients with parvovirus B19 infection. Monographs in virology: human parvovirus B19. New York: Karger; 1997: 61.

  29. Mortimer P, Humphries R, Moore J et al. A human parvovirus-like virus inhibits haematopoietic colony formation in vitro. Nature 1983; 302: 426–9.

  30. Erdman D, Usher J, Tsou C et al. Human parvovirus B19 specific IgG, IgA, and IgM antibodies and DNA in serum specimens from persons with erythema infectiosum. J Med Virol 1991; 35: 110–5.

  31. Cassinotti P, Burtonboy G, Fopp M, Siegl G. Evidence for persistence of human parvovirus B19 DNA in bone marrow. J Med Virol 1997; 53: 229–232.

  32. Gullo A, Bianco N, Berlot G. Management of severe sepsis and septic shock: Challenges and recommendations. Crit Care Clin 2006; 22: 489.

  33. Alejandria MM, Lansang MA, Dans LF, Mantaring JBV. Intravenous immunoglobulin for treating sepsis and septic shock. Cochrane review. In: The Cochrane Library, Issue 3, 2003, Oxford: Update Software.

  34. Tugrul S, Ozcan PE, Akinci O, Seyhun H, Cagatay A, Cakar N et al. The effects of IgM-enriched immunoglobulin preparations in patients with severe sepsis. Crit Care 2002; 6: 357-62.

  35. Darenberg J, Ihendyane N, Sjolin J, Aufwerber E, Haidl S, Follin P et al. Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: A European randomized, double-blind, placebo-controlled trial. Clin Infect Dis 2003; 37: 333-40, 28.




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