The Evaluation of Treatment and Management Candida Esophagitis caused by Candida krusei in the Diabetic and Pregnant Patient

Yıl 2010, Cilt: 15 Sayı: 2, 113 - 115, 01.04.2010

Kutbettin Demirdağ Özlem Çağaşar

Öz

In this case report aimed to present a 27-years old diabetic pregnant woman with candida esophagitis caused by Candida krusei. Because of refractory nause, vomiting and unanswered to empiric treatment for upper respiratory tract bacterial infections, gastroscopy was performed and candida esophagitis was diagnosed. Empirical fluconazole treatment was started. At fourteenth day of fluconazole treatment her symptoms did not resolve and candida crusei was identified from endoscopic tissue culture therefore her treatment was accepted fluconazole resistant and treatment was changed to caspofungin. Follow-up nausea, vomiting, difficulty swallowing decreased but had been going on sometimes. Patient's treatment was completed at 81 days. At the end of the treatment her signs and symptoms disappeared. In conclusion, candida esophagitis should be considered among the differential diagnosis of pregnant patients who are nonrespondent to symptomatic treatment for refractory nause, vomiting and weight loss. Additionally etiologic agent and disease progress can be different and therapy should be planned long time considering underlying disease.

Anahtar Kelimeler

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Diyabetik Gebe Bir Hastada Candida Krusei'nin Neden Olduğu Yaygın Özefajit Olgusunun Tedavi ve Takip Yönünden İrdelenmesi

Öz

Bu olgu sunumunda 27 yaşında diyabetik gebe bir hastada nadir görülen Candida krusei özefajitinin sunulması amaçlanmıştır. İnatçı bulantı, kusma ve üst solunum yolu bakteriyel enfeksiyonuna yönelik verilen ampirik tedaviye cevap alınamaması nedeniyle gastroskopi yapıldı ve kandida özefajiti tanısı konuldu. Ampirik flukonazol tedavisi başlandı. Tedavinin ondördüncü gününde hastanın semptomlarının gerilememesi ve boğazdaki plaklardan alınan kültürde Candida krusei üremesi üzerine hastanın tedavisi kaspofungin ile değiştirildi. Takiplerinde şikayetleri azalmakla birlikte ara ara bulantı, kusma, yutma güçlüğü şikayetleri devam eden hastanın tedavisi 81 güne tamamlandı. Tedavi sonunda semptom ve bulguları kayboldu. Sonuç olarak gebelikte semptomatik tedavi ile gerilemeyen inatçı bulantı, kusma ve kilo kaybının eşlik ettiği özefajit olgularında ayırıcı tanıda kandida özefajitinin düşünülmesi, kandida özefajiti saptanan olgularda ise tedavinin planlanması amacıyla kandida tiplendirilmesinin yapılması gerektiği ve hastanın altta yatan hastalıkları göz önünde bulundurularak tedavinin uzun süreli planlanması gerektiği düşünülmüştür.

Anahtar Kelimeler

Diyabet, gebelik, C. krusei özefajiti

Kaynakça

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