Infections in the immunocompromised patient, about a case of Systemic Sclerosis
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Abstract
Introduction: Sclerosis is a chronic, degenerative, disabling and lethal disease that affects thousands of people.
Its variable clinical presentation has made it a diagnostic challenge, delaying timely treatment. In Ecuador,
exact statistical data on the number of patients with this pathology are not known. The use of immunosuppression
therapies to treat this disease has made the patient an easy target for opportunistic pathogen infections
that often go unnoticed. Tuberculosis infection is of high concern in these patients, especially when
corticosteroid therapy plus immunosuppressants are administer for a long time.
Objective: To describe the effects of prolonged use of immunosuppressants and susceptibility to infections by
opportunistic pathogens.
Material and methods: Retrospective descriptive study, clinical case presentation of a female patient diagnosed
with multiple sclerosis with prolonged immunosuppressive treatment who is incidentally diagnosed
with tuberculosis.
Results: The case of a patient is presented of a 46-year-old female patient with a history of systemic sclerosis
who was treated 18 years ago with prednisone 5 and 10 mg, mycophenolate mofetil 500 mg every day, with a
history of cancer, who was admitted after presenting varied symptoms with ineffective treatment. Chest tomography
was performed, showing cavitated cystic lesion in the left lung field, with an apparent infiltrate,
renal function, electrolytes and arterial blood gas within normal parameters and a positive result sputum
BAAR, for which antifimic treatment was started.
Conclusions: It is of great importance that all health professionals who care for this type of patient have full
knowledge of this pathology, of possible complications and the risk of latent infection due to the disease or
due to immunosuppression therapies. Emphasis should be placed on carrying out strategies and protocols for
the correct monitoring of patients within the National Health System.
