Özofagusun fungal enfeksiyonları; tek merkez deneyimi

Year 2019, , 7 - 11, 15.04.2019

Enver Akbaş

https://doi.org/10.17940/endoskopi.570941

Cited By: 1

Abstract

Giriş ve Amaç: Araştırmamızda hastanemizde çeşitli endikasyonlar
ile üst
gastrointestinal sistem endoskopisi yapılan hastalarda özofagus fungal enfeksiyonlarının
sıklığını, başvuru semptomlarının dağılımını, buna zemin hazırlayan durumları
değerlendirmeye çalıştık. Gereç ve Yöntem: 2015-2019 yılları arasında hastanemize başvuran ve üst gastrointestinal
sistem endoskopisi yapılan 2862 hastadan endoskopik olarak özofagusta fungal
enfeksiyon tespit edilen ve mikrobiyolojik olarak bu tanısı doğrulanan 33 hasta
değerlendirmeye alındı. Bulgular:
Toplam 2862 hastanın 33 (%1,2) tanesinde özofagusta fungal enfeksiyon
tespit edildi. Eşlik eden hastalık olarak en sık %71 ile reflü özofajit
zemininde fungal enfeksiyon gelişmişti. Hiçbir hastada insan bağışıklık
yetmezliği virüsü pozitifliği tespit edilemedi. Hastaların %27,3’ünde immünsupresyona
neden olan bir patoloji ya da ilaç kullanımı mevcut iken %72,7’sinde böyle bir
neden tespit edilemedi. Hastaların başvuru şikayeti olguların %21.2’sinde disfaji, %6.1’inde hıçkırık, %21.2’sinde reflü semptomları, %6.1’inde ses kısıklığı, %6.1’inde kilo kaybı, %15.2’sinde
bulantı-kusma iken %42.4 ile hastaların çoğunluğunda mide ağrısı gibi klasik
bir dispeptik yakınma şeklindeydi. Sonuç: Dünyada Kandida özofajitinin en sık nedeni insan bağışıklık
yetmezliği virüsü enfeksiyonu, maligniteler ve immünsüpresyon yaratan durumlardır.
Bizim hastalarımızda Kandida enfeksiyonuna daha çok reflü özofajit eşlik
etmekte iken sadece %15 hastada enfeksiyon immünsüpresyon yaratan bir durumda
gelişmişti. Bulgularımız insan bağışıklık yetmezliği virüsü negatif
hasta profilindeki dünya literatür verileri ile uyumu bulundu.

Keywords

Özofagusun fungal enfeksiyonları, kandida özofajiti, kandidiyazis

Fungal infections of the esophagus: Single center experience

Abstract

Background and Aims: Our study investigated the prevalence of esophageal
fungal infections, distribution of presenting symptoms, and predisposing
conditions in the patients undergoing upper gastrointestinal endoscopy for
various reasons at our hospital. Materials
and Methods: Overall, 2862 patients presented to our hospital and
underwent upper gastrointestinal endoscopy between 2015 and 2019. Thirty-three of these patients who were endoscopically determined and
microbiologically confirmed to have esophageal fungal infections were included.
Results: Esophageal fungal infection
was found in 33 (1.2%) of 2862 patients. Fungal infections developed most
frequently as a comorbid disease in the setting of reflux esophagitis, with a
rate of 71%. No
patient was found to have human immunodeficiency virus seropositivity. Even
though 27.3% of patients had pathological or drug-induced immune suppression,
no such findings were noted  in
72.7% of patients. The presenting complaint was dysphagia in 21.2% of patients,
hiccough in 6.1%, reflux symptoms in 21.2%, hoarseness in 6.1%, weight loss in
6.1%, and nausea or vomiting in 15.2%; however, in most patients,
the presenting complaint was a classical dyspeptic complaint, such as stomach ache
(42.4%). Conclusion: The most common causes of Candida esophagitis
worldwide are human immunodeficiency virus infection, malignancies,
and conditions that result in immune suppression. Even though Candida
esophagitis was more commonly associated with reflux esophagitis in our
patients, fungal infection was also observed in 15% of patients along with
diseases that rendered them immunocompromized. Our results were concordant with
the literature data regarding the clinical profile of patients who are human
immunodeficiency virus negative.

Keywords

Fungal infections of the esophagus, Candida esophagitis, candidiasis

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