Case Report
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A Case of Atypical Alternaria Alternata Causing Allergic Rhinitis

Year 2020, Volume: 14 Issue: 2, 345 - 348, 20.01.2020
https://doi.org/10.21763/tjfmpc.649583

Abstract

Allergic rhinitis is an IgE-mediated inflammatory disease of the nasal mucosa, associated with various inhalant allergens, such as house dust mites, pollens, and molds. An 11-year-old male patient presented to the Primary Care Clinic with nasal discharge and congestion, itchy throat and eyes, and poor sleep quality. Antihistamine was recommended to the patient. However, as his symptoms were not relieved after nearly one month, he was referred to the Pediatric Allergy Outpatient Clinic to determine the allergens. The tests showed that the patient had elevated IgE and, according skin prick test, was sensitive to Alternaria alternata. His family was then informed of his mold allergy. The patient presented to, with his family stating that had examined the entire house, they found mold on the doorseal of the washing machine located in the hall way to which the child’s room is connected, and that all his complaints disappeared shortly after theyre placed this seal. Here a case of Alternaria alternata with atypical localization stemming from the mold in the washing machine is presented and is assumed to have caused allergic rhinitis. It was reason that it is important to determine specific, while it should be remembered that molds can also be present in modern houses.


Alerjik rinit, burun mukozasının IgE aracılığıyla oluşan enflamatuvar bir hastalığı olup ev tozu akarları, polenler ve küfler gibi çok çeşitli inhalan alerjenlerle ilişkilidir. Burun akıntısı, tıkanıklılığı, boğaz ve gözlerde kaşıntı, rahat uyuyamama şikayetleri olan 11 yaşındaki erkek hasta Aile Sağlığı Merkezine başvurdu. Yaklaşık 1 ay kadar antihistaminik önerilen hastanın şikayetlerinin geçmemesi üzerine alerji etkeninin belirlenmesi amacıyla Çocuk Alerji Polikliniğine yönlendirildi. Hastanın burada yapılan tetkiklerinde IgE yüksekliği ve deri prick testinde Alternaria alternataya duyarlı olduğu saptandı ve aileye küf alerjisi olduğu bildirildi. Tekrar Aile Sağlığı Merkezine başvuran hastanın ailesi ile görüşüldüğünde evdeki tüm ortamların araştırıldığı, çocuğun odasının açıldığı koridorda bulunan çamaşır makinesinin kapağındaki lastikte küf tespit edildiği ve bu lastik değiştirildikten kısa bir süre sonra çocuğun tüm şikayetlerinin ortadan kalktığı öğrenildi. Burada çamaşır makinesi içindeki küften kaynaklanan ve alerjik rinite neden olduğu varsayılan atipik yerleşimli Alternaria alternata olgusu sunulmuştur. Sonuç olarak alerjik riniti olan hastalarda spesifik alerjenin belirlenmesi ve çevre kontrolü yapılması önemlidir ve modern evlerde de küflerin olabileceği unutulmamalıdır.

References

  • 1. Mosca F, Giannì ML. Human milk: composition and health benefits. Pediatr Med Chir 2017;39(2):155.
  • 2. Colchero MA, Contreras-Loya D, Lopez-Gatell H, Gonzálezde Cosío T. The costs of inadequate breastfeeding of infants in Mexico. Am J Clin Nutr 2015;101(3):579-86.
  • 3. Binns C, Lee M, Low WY. The Long-TermPublic Health Benefits of Breastfeeding. AsiaPac J Public Health 2016;28(1):7-14.
  • 4. WHO/UNICEF. Global strategy for infant and Young Child feeding. Geneva: World Health Organization;2003 https://apps.who.int/iris/bitstream/handle/10665/42590/9241562218.pdf;jsessionid=D1A4DE0B1E5F455D6C79E6C0BB16C7D6?sequence=1 Erişim tarihi:03.05.2019
  • 5. Victora CG, Bahl R, Barros AJ, et al. Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and life long effect. The Lancet 2016; 387(10017): 475-490.
  • 6. Türkiye Nüfus ve Sağlık Araştırması Temel Bulgular. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü, Ankara,2018.p.139-145 http://www.hips.hacettepe.edu.tr/tnsa2018/rapor/TNSA_2018_ana_Rapor.pdf (Erişim tarihi 29.12.2019)
  • 7. Neifert M, Bunik M. Overcoming clinical barriers to exclusive breastfeeding. Pediatr Clin North Am 2013;60(1):115-45.
  • 8. Odom EC, Li R, Scanlon KS, Perrine CG, Grummer-Strawn L. Reasons for earlier than desired cessation of breastfeeding. Pediatrics 2013;131(3):e726–e732.
  • 9. Sattari M, Levine D, Neal D, Serwint JR. Personal breastfeeding behavior of physician mothers is associated with their clinical breastfeeding advocacy. Breastfeed Med 2013;8(1):31–37.
  • 10. Labarere J. Gelbert-Baudino N. Aryal AS, et al. Efficacy of breastfeeding support provided by trained clinicians during an early, routine, preventive visit: A prospective, randomized, opentrial of 226 mother-infantpairs. Pediatrics. 2005;115:e139–e146.
  • 11. Brodribb WE, Jackson C, Fallon AB, Hegney D. Gender and personal breastfeeding experience of rural GP registrars in Australia--a qualitative study of their effect on breastfeeding attitudes and knowledge. Rural Remote Health 2007;7(3):737.
  • 12. Feldman-Winter, LB, Schanler R J, O’Connor, K. G, Lawrence, RA. Pediatricians and the promotion and support of breastfeeding. Arch Pediatr Adolesc Med. 2008; 162(12): 1142-1149.
  • 13. Sattari M, Levine D, Bertram A, Serwint JR. Breastfeeding intentions of female physicians. Breastfeed Med 2010; 5: 297–302.
  • 14. Nkoka O, Ntenda PAM, Kanje V, Milanzi EB, Arora A. Determinants of timely initiation of breastmilk and exclusive breastfeeding in Malawi: a population-based cross-sectional study. Int Breastfeed J. 2019;14:37.
  • 15. Stevens J, Schmied V, Burns E, Dahlen H. Immediate or early skin-to-skin contact after a caesarean section: a review of the literature. Matern Child Nutr 2014;10(4):456-73. 16. WHO Statement on Caesarean Section Rates. p.1-2. https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1 Erişim tarihi:09.07.2019
  • 17. Bag O. Karaaslan U. TheAttitude of female pediatricians towards birth, breastfeeding and child care on their own children in Turkey. J Pediatr Res 2018;5(2):92-7.
  • 18. Al-Binali AM. Knowledge, attitude and practice of breast-feeding among female health care workers in tertiary care hospitals. Med J CairoUniv 2012;80(1):159–64.
  • 19. Renitha R, Babu TA, Kumar M, Srinivasan S. Breastfeeding practices among health care professionals in a tertiary care hospital from South India. Indian J Public Health 2012 ;56(2):149-51.
  • 20. Dachew BA, Bifftu BB. Breastfeeding practice and associated factors among female nurses and midwives at North GondarZone, Northwest Ethiopia: a cross-sectional institution basedstudy. Int Breastfeed J. 2014;21:9-11.
  • 21. Yaman H. Akçam M. Breastfeeding practices of health professionals and care workers in Turkey. Coll Antropol 2004;28(2): 877–84.
  • 22. Olang B, Heidarzadeh A, Strandvik B, Yngve A. Reasons given by mothers for discontinuing breastfeeding in Iran. Int Breastfeed J 2012;7(1):7.
  • 23. Yılmaz E, Ocal FD, Yılmaz ZV, Ceyhan M, Kara OF, Küçüközkan T. Early initiation and exclusive breastfeeding: Factors influencing the attitudes of mothers who gave birth in a baby-friendly hospital. Turk J Obstet Gynecol 2017;14(1):1–9.
  • 24. Buccini GDS, Pérez-Escamilla R, Paulino LM, Araújo CL, Venancio SI. Determinants of using pacifier and bottle feeding. Matern Child Nutr 2017;13(3).
  • 25. Tunçel E, Dündar C, Pekşen Y. Ebelerin anne sütü ile ilgili bilgi ve uygulamalarının değerlendirilmesi. Kocatepe Tıp Dergisi 2005;6(1):43-48.
  • 26. Güraslan Baş N, Karatay G. Arikan D. Weaning practices of mothers in eastern Turkey. J Pediatr 2018; 94(5), 498-503.
  • 27. Duke PS, Parsons WL, Snow PA, Edwards AC. Physicians as mothers breastfeeding practices of physician-mothers in New foundland and Labrador. Can Fam Physician 2007;53(5):887-91.

Allerjik Rinite Neden Olan Atipik Yerleşimli Alternaria Alternata Olgusu

Year 2020, Volume: 14 Issue: 2, 345 - 348, 20.01.2020
https://doi.org/10.21763/tjfmpc.649583

Abstract

Alerjik rinit, burun mukozasının IgE aracılığıyla oluşan enflamatuvar bir hastalığı olup ev tozu akarları, polenler ve küfler gibi çok çeşitli inhalan alerjenlerle ilişkilidir. Burun akıntısı, tıkanıklılığı, boğaz ve gözlerde kaşıntı, rahat uyuyamama şikayetleri olan 11 yaşındaki erkek hasta Aile Sağlığı Merkezine başvurdu. Yaklaşık 1 ay kadar antihistaminik önerilen hastanın şikayetlerinin geçmemesi üzerine alerji etkeninin belirlenmesi amacıyla Çocuk Alerji Polikliniğine yönlendirildi. Hastanın burada yapılan tetkiklerinde IgE yüksekliği ve deri prick testinde Alternaria alternataya duyarlı olduğu saptandı ve aileye küf alerjisi olduğu bildirildi. Tekrar Aile Sağlığı Merkezine başvuran hastanın ailesi ile görüşüldüğünde evdeki tüm ortamların araştırıldığı, çocuğun odasının açıldığı koridorda bulunan çamaşır makinesinin kapağındaki lastikte küf tespit edildiği ve bu lastik değiştirildikten kısa bir süre sonra çocuğun tüm şikayetlerinin ortadan kalktığı öğrenildi. Burada çamaşır makinesi içindeki küften kaynaklanan ve alerjik rinite neden olduğu varsayılan atipik yerleşimli Alternaria alternata olgusu sunulmuştur. Sonuç olarak alerjik riniti olan hastalarda spesifik alerjenin belirlenmesi ve çevre kontrolü yapılması önemlidir ve modern evlerde de küflerin olabileceği unutulmamalıdır.

References

  • 1. Mosca F, Giannì ML. Human milk: composition and health benefits. Pediatr Med Chir 2017;39(2):155.
  • 2. Colchero MA, Contreras-Loya D, Lopez-Gatell H, Gonzálezde Cosío T. The costs of inadequate breastfeeding of infants in Mexico. Am J Clin Nutr 2015;101(3):579-86.
  • 3. Binns C, Lee M, Low WY. The Long-TermPublic Health Benefits of Breastfeeding. AsiaPac J Public Health 2016;28(1):7-14.
  • 4. WHO/UNICEF. Global strategy for infant and Young Child feeding. Geneva: World Health Organization;2003 https://apps.who.int/iris/bitstream/handle/10665/42590/9241562218.pdf;jsessionid=D1A4DE0B1E5F455D6C79E6C0BB16C7D6?sequence=1 Erişim tarihi:03.05.2019
  • 5. Victora CG, Bahl R, Barros AJ, et al. Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and life long effect. The Lancet 2016; 387(10017): 475-490.
  • 6. Türkiye Nüfus ve Sağlık Araştırması Temel Bulgular. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü, Ankara,2018.p.139-145 http://www.hips.hacettepe.edu.tr/tnsa2018/rapor/TNSA_2018_ana_Rapor.pdf (Erişim tarihi 29.12.2019)
  • 7. Neifert M, Bunik M. Overcoming clinical barriers to exclusive breastfeeding. Pediatr Clin North Am 2013;60(1):115-45.
  • 8. Odom EC, Li R, Scanlon KS, Perrine CG, Grummer-Strawn L. Reasons for earlier than desired cessation of breastfeeding. Pediatrics 2013;131(3):e726–e732.
  • 9. Sattari M, Levine D, Neal D, Serwint JR. Personal breastfeeding behavior of physician mothers is associated with their clinical breastfeeding advocacy. Breastfeed Med 2013;8(1):31–37.
  • 10. Labarere J. Gelbert-Baudino N. Aryal AS, et al. Efficacy of breastfeeding support provided by trained clinicians during an early, routine, preventive visit: A prospective, randomized, opentrial of 226 mother-infantpairs. Pediatrics. 2005;115:e139–e146.
  • 11. Brodribb WE, Jackson C, Fallon AB, Hegney D. Gender and personal breastfeeding experience of rural GP registrars in Australia--a qualitative study of their effect on breastfeeding attitudes and knowledge. Rural Remote Health 2007;7(3):737.
  • 12. Feldman-Winter, LB, Schanler R J, O’Connor, K. G, Lawrence, RA. Pediatricians and the promotion and support of breastfeeding. Arch Pediatr Adolesc Med. 2008; 162(12): 1142-1149.
  • 13. Sattari M, Levine D, Bertram A, Serwint JR. Breastfeeding intentions of female physicians. Breastfeed Med 2010; 5: 297–302.
  • 14. Nkoka O, Ntenda PAM, Kanje V, Milanzi EB, Arora A. Determinants of timely initiation of breastmilk and exclusive breastfeeding in Malawi: a population-based cross-sectional study. Int Breastfeed J. 2019;14:37.
  • 15. Stevens J, Schmied V, Burns E, Dahlen H. Immediate or early skin-to-skin contact after a caesarean section: a review of the literature. Matern Child Nutr 2014;10(4):456-73. 16. WHO Statement on Caesarean Section Rates. p.1-2. https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1 Erişim tarihi:09.07.2019
  • 17. Bag O. Karaaslan U. TheAttitude of female pediatricians towards birth, breastfeeding and child care on their own children in Turkey. J Pediatr Res 2018;5(2):92-7.
  • 18. Al-Binali AM. Knowledge, attitude and practice of breast-feeding among female health care workers in tertiary care hospitals. Med J CairoUniv 2012;80(1):159–64.
  • 19. Renitha R, Babu TA, Kumar M, Srinivasan S. Breastfeeding practices among health care professionals in a tertiary care hospital from South India. Indian J Public Health 2012 ;56(2):149-51.
  • 20. Dachew BA, Bifftu BB. Breastfeeding practice and associated factors among female nurses and midwives at North GondarZone, Northwest Ethiopia: a cross-sectional institution basedstudy. Int Breastfeed J. 2014;21:9-11.
  • 21. Yaman H. Akçam M. Breastfeeding practices of health professionals and care workers in Turkey. Coll Antropol 2004;28(2): 877–84.
  • 22. Olang B, Heidarzadeh A, Strandvik B, Yngve A. Reasons given by mothers for discontinuing breastfeeding in Iran. Int Breastfeed J 2012;7(1):7.
  • 23. Yılmaz E, Ocal FD, Yılmaz ZV, Ceyhan M, Kara OF, Küçüközkan T. Early initiation and exclusive breastfeeding: Factors influencing the attitudes of mothers who gave birth in a baby-friendly hospital. Turk J Obstet Gynecol 2017;14(1):1–9.
  • 24. Buccini GDS, Pérez-Escamilla R, Paulino LM, Araújo CL, Venancio SI. Determinants of using pacifier and bottle feeding. Matern Child Nutr 2017;13(3).
  • 25. Tunçel E, Dündar C, Pekşen Y. Ebelerin anne sütü ile ilgili bilgi ve uygulamalarının değerlendirilmesi. Kocatepe Tıp Dergisi 2005;6(1):43-48.
  • 26. Güraslan Baş N, Karatay G. Arikan D. Weaning practices of mothers in eastern Turkey. J Pediatr 2018; 94(5), 498-503.
  • 27. Duke PS, Parsons WL, Snow PA, Edwards AC. Physicians as mothers breastfeeding practices of physician-mothers in New foundland and Labrador. Can Fam Physician 2007;53(5):887-91.
There are 26 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section Case Report
Authors

Hatice Tuba Akbayram 0000-0002-9777-9596

Publication Date January 20, 2020
Submission Date November 21, 2019
Published in Issue Year 2020 Volume: 14 Issue: 2

Cite

Vancouver Akbayram HT. Allerjik Rinite Neden Olan Atipik Yerleşimli Alternaria Alternata Olgusu. TJFMPC. 2020;14(2):345-8.

English or Turkish manuscripts from authors with new knowledge to contribute to understanding and improving health and primary care are welcome.