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Mujer de 43 años presenta disminución de agudeza visual en ojo derecho. En la evaluación, se encuentran lesiones retinianas «en bolas de nieve» en ambos ojos. En ausencia de mejoría con tratamiento empírico antifúngico intravítreo, se realiza cultivo de vítreo y se halla Candida glabrata. La paciente recibe anfotericina B intravítrea y tratamiento sistémico con caspofungina y anfotericina B complejo lipídico.

At the Anual SLAIP Meeting in 1988 we presented the method of procedure and biochemical features of a Nat obtained by bronchioalveolar lavage of bovine lungs. This product is how being elaborated by an Argentinan laboratory. Between 8-1-90 and 7-31-91, 40 premature infants (Pret) less than 37 weeks gestational age, diagnosed a HMD and in mechanical ventilation, were treated by tracheal insulation with Nat (90mg/kg) in the first hours of life. Additional doses were given up to 48 hs., based on clinical requirements. The treated group had a birth weight of [xmacr ]=1268gr (r=630-2470) and a gestational age of [xmacr ]=29.1 weeks (r=23-36). The first dose was administered at [xmacr ]=4.7hs. (r=0.5-24). Before it the FiO2 was [xmacr ]=0.81 (SD=0.2), the PaO2 [xmacr ]=59mmhg (SD=15) and the mean airway pressure (Paw) [xmacr ]=9.2cm H2O (SD=3.8). Ten minutes afterwards the PaO2 was [xmacr ]=145mmHg (SD=51)(p < 0.001). One hour late the FiO2 was [xmacr ]=0.54 (SD=0.28) (p < 0.001) and the difference was maintained during the first 72 hours. The Raw decreased significantly only after 12 hs [xmacr ] Paw=7,4cm H2O DS=3.2 p=0.02). Each patient received a mean of 2.1 doses. Sixteen Pret (40%) required only one dose, 16 (40%) received a second dose (age [xmacr ]=8.7hs r=2.5-2.4) and the remaining 8 (20%) three or four doses. From 17 Pret with birth weights < 1000gr., 10 died (58%), 7 from causes associated with the HMD There were no deaths in the 23 Pret with birthweights > 1000gr. Seven patients (17.5%) had air leaks (4 pneumothorax and 4 interstitial emphysema). Three Pret developed bronchopulmonary dysplasia. Nat may be helpful in the treatment of the HMD in Pret.