Tuberculosis pleuropulmonar en paciente con terapia biológica: una reactivación a pesar de la profilaxis
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Millones de personas están infectadas por Mycobacterium tuberculosis y entre el 5% y el 10% de ellas padecerán tuberculosis. Los inhibidores del TNFα se asocian con la progresión de la infección tuberculosa a la enfermedad tuberculosa. Presentamos el caso de una mujer de 43 años que recibió profilaxis estándar para infección tuberculosa previa al tratamiento con adalimumab y que, posteriormente, desarrolló tuberculosis pleuropulmonar, confirmada mediante histopatología. Los estudios microbiológicos disponibles no permitieron evaluar la resistencia a la isoniazida ni distinguir entre el fracaso del tratamiento preventivo y la reinfección. Surge la interrogante de si un tratamiento alternativo habría prevenido la reactivación de la tuberculosis.
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