Peritonitis candidiásica | Enfermedades Infecciosas y Microbiología Clínica

Información del artículo

Resumen

Debido a que Candida spp. es un componente de la flora endógena del tubo digestivo, puede formar parte de la etiología de prácticamente cualquier tipo de infección abdominal. Es frecuente, por ello, aislar Candida spp. en las peritonitis secundarias polimicrobianas por dehiscencia de suturas intestinales. En estos casos no hay acuerdo claro acerca de cuando el aislamiento de Candida spp. en drenajes peritoneales representa infección y no colonización. La recomendación general es interpretar que hay infección cuando la muestra en la que se identifica el germen es intraoperatoria o se ha obtenido mediante punción directa de la colección intraabdominal. Cuando se cultiva Candida spp. en las muestras de drenajes tomadas posteriormente es posible que se trate de una simple colonización. Sin embargo, cuando estos cultivos se acompañan de signos de sepsis, el paciente reúne criterios de gravedad o bien se aísla Candida spp. repetidamente, la mayoría de los intensivistas deciden iniciar tratamiento antifúngico. Este tratamiento es similar para candidemias, candidiasis invasivas diseminada y peritonitis candidiásica.

Palabras clave:

Peritonitis candidiásica

Candida spp.

Candidiasis invasiva

Abstract

Candida spp. is a component of the endogenous flora of the digestive tract and can consequently form part of the etiology of almost any type of abdominal infection. Candida spp. is therefore frequently isolated in polymicrobial secondary peritonitis due to intestinal suture dehiscence. In these cases, there is no clear consensus on when Candida spp. isolation in peritoneal drainage fluid represents infection rather than colonization. The general recommendation is to interpret that there is infection when the sample containing the pathogen is intraoperative or has been obtained directly from the intraabdominal collection. When Candida spp. is cultured in samples from subsequently obtained drainage fluid, colonization is a possibility. However, when these cultures are accompanied by signs of sepsis, the patient shows severity criteria or Candida spp. is repeatedly isolated, most intensivists decide to begin antifungal therapy. This treatment is similar for candidemias, disseminated invasive candidiasis and Candida peritonitis.

Keywords:

Candida peritonitis

Candida spp.

Invasive candidiasis

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