BibTex RIS Kaynak Göster

SUBAKUT NEKROTİZAN PULMONER ASPERGİLLOZİS: OLGU SUNUMU

Yıl 2004, Cilt: 18 Sayı: 2, 83 - 88, 01.10.2004

Öz

Kronik nekrotizan pulmoner aspergillozis genellikle var olan akciğer hastalığı veya immun sistem bozukluğu nedeniyle meydana gelen lokal savunma bozukluğu olan hastalarda görülen subakut bir enfeksiyondur. Altmış bir yaşında KOAH tanısı olan erkek hasta siyanoz, ilerleyici dispne ve balgam çıkarma yakınması ile başvurdu. İki hafta süreli geniş spektrumlu antibiotik, bronkodilatatör ve steroid tedaviye rağmen semptomları ilerledi. Göğüs radyografisi ve BT'de sol alt lob superior segmentte infiltrasyon görüldü. 1 ay içinde klinik durumu bozuldu ve aynı dönemde çekilen BT'de sol alt lobda miçetoma içeren kavite ve plevral efüzyon görüld ü. Bronşial lavaj ve balgam kültüründe Aspergillus sp. üredi ve malignite saptanmadı. Başlanan Amfoterisin B lipid kompleks tedavisi ile tedaviden 1 ay sonra klinik ve radyolojik bulgularda düzelme saptandı. Tedaviye İtrakonazol ile devam edildi, başlangıç semptomları geriledi ve radyografik düzelme devam etti. Olgumuzu erken tanınıp tedavi edilmiş olması ve tedavinin başarılı olması nedeniyle literatür eşliğinde sunduk.

Kaynakça

  • 1. Dokuzo¤uz B. HIV/AIDS ve f›rsatç› infeksiyonlar. Uzun Ö, Ünal S (ed). Güncel bilgiler ›fl›¤›nda infeksiyon hastal›klar›. Ankara: Bilimsel T›p Yay›nevi 2002; 969-82.
  • 2. Sugar MA, Olek EA. Aspergillus syndromes, mucormycosis and pulmonary candidiasis. In: Fishman PA(ed). Pulmonary diseases and disorders. New York. Mc Graw-Hill Com. 1998: 2266-87.
  • 3. SaracenoJL, Phelps DT, Ferro TJ, Futerfas R, Schwartz DB. Chronic necrotizing pulmonary aspergillosis. Aproach to management. Chest 1997; 112: 541-8.
  • 4. Tabak L. Akci¤erin fungal infeksiyonlar›, Nokardiyoz, Aktinomikoz. Arseven O(ed). Akci¤er Hastal›klar›. ‹stanbul, Nobel T›p Kitabevi 2002: 263-72.
  • 5. Hafeez I, Muers MF, Murphy SA, Evans EGV, Barton RC, McWhinney P. Non-tuberculous mycobacterial lung infection complicated by chronic necrotising pulmonary aspergillosis. Thorax 2000; 55: 717-9.
  • 6. Filippou N, Papachristou K, Ilias I, Pefanis A, et al. Case report. Chronic necrotizing pulmonary aspergillosis in non-neutropenic patient treated with liposomal ambhotericin B. Mycoses 2000; 43(7-8): 313-5.
  • 7. Caras WE, Pluss JL. Chronic necrotizing pulmonary aspergillosis: pathologic outcome after itraconazole therapy. Mayo Clin Proc 1996; 71: 25-30.
  • 8. Kimmerling EA, Fedrick JA, Tenholder MF. Invasive aspergillosis niger with fatal pulmonary oxalosis in chronic obstructive pulmonary disease. Chest 1992; 101: 870-2.
  • 9. Eliot JA, Milne LJR, Cumming D. Chronic necrotizing pulmonary aspergillosis treated with itraconazole. Thorax 1989; 44: 820-1.
  • 10. Franquet T, Müller NL, Gimenez A, Domingo P, et al. Semiinvasive pulmonary aspergillosis in chronic obstructive pulmonary disease. AJR 2000; 174: 51-6.
  • 11. Klein NC, Cunha BA. New antifungal drugs for pulmonary mycoses. Chest 1996; 110: 525-32.
  • 12. Wong PC, Fung SL, Lee J, Wong CF, et al. Chronic necrotizing pulmonary aspergillosis. A report of 9 cases with analysis of clinical picture, risk factors and treatment for outcome correlation. Monaldi Arch Chest Dis 2001; 56(3): 202-7

SUBACUTE NECROTIZING PULMONARY ASPERGILLOSIS: CASE REPORT

Yıl 2004, Cilt: 18 Sayı: 2, 83 - 88, 01.10.2004

Öz

Chronic necrotizing pulmonary aspergillozis is a subacute infection most commonly seen in patients with altered local defense due to preexisting pulmonary disease or in patients with risk factors that alter systemic immune status. A sixtyone-year-old male patient diagnosed with COPD presented cyanosis, worsening dyspnea and sputum production. Despite two weeks of broad-spectrum antibiotic, bronchodilatator and steroid therapy, his symptoms progressed. His chest radiograph and CT scan revealed an infiltration at superior segment of left lower lobe (LLL). In 1 month, his clinical condition deteriorated and subsequent CT scan showed cavitiy in LLL with mycetoma and pleural effusion. Aspergillus sp. grew in bronchial washing and sputum cultures and cytology revealed no malignancy. After 1 months of treatment with amphoterisin B lipid complex (ABLC), clinic and radiographic findings improved significantly. Therapy continued with itraconazole, during 3 months and his initial symptoms resolved and radiographic improvement is continued. We report this case as he was early diagnosed and treated successfully by reviewing the literature.

Kaynakça

  • 1. Dokuzo¤uz B. HIV/AIDS ve f›rsatç› infeksiyonlar. Uzun Ö, Ünal S (ed). Güncel bilgiler ›fl›¤›nda infeksiyon hastal›klar›. Ankara: Bilimsel T›p Yay›nevi 2002; 969-82.
  • 2. Sugar MA, Olek EA. Aspergillus syndromes, mucormycosis and pulmonary candidiasis. In: Fishman PA(ed). Pulmonary diseases and disorders. New York. Mc Graw-Hill Com. 1998: 2266-87.
  • 3. SaracenoJL, Phelps DT, Ferro TJ, Futerfas R, Schwartz DB. Chronic necrotizing pulmonary aspergillosis. Aproach to management. Chest 1997; 112: 541-8.
  • 4. Tabak L. Akci¤erin fungal infeksiyonlar›, Nokardiyoz, Aktinomikoz. Arseven O(ed). Akci¤er Hastal›klar›. ‹stanbul, Nobel T›p Kitabevi 2002: 263-72.
  • 5. Hafeez I, Muers MF, Murphy SA, Evans EGV, Barton RC, McWhinney P. Non-tuberculous mycobacterial lung infection complicated by chronic necrotising pulmonary aspergillosis. Thorax 2000; 55: 717-9.
  • 6. Filippou N, Papachristou K, Ilias I, Pefanis A, et al. Case report. Chronic necrotizing pulmonary aspergillosis in non-neutropenic patient treated with liposomal ambhotericin B. Mycoses 2000; 43(7-8): 313-5.
  • 7. Caras WE, Pluss JL. Chronic necrotizing pulmonary aspergillosis: pathologic outcome after itraconazole therapy. Mayo Clin Proc 1996; 71: 25-30.
  • 8. Kimmerling EA, Fedrick JA, Tenholder MF. Invasive aspergillosis niger with fatal pulmonary oxalosis in chronic obstructive pulmonary disease. Chest 1992; 101: 870-2.
  • 9. Eliot JA, Milne LJR, Cumming D. Chronic necrotizing pulmonary aspergillosis treated with itraconazole. Thorax 1989; 44: 820-1.
  • 10. Franquet T, Müller NL, Gimenez A, Domingo P, et al. Semiinvasive pulmonary aspergillosis in chronic obstructive pulmonary disease. AJR 2000; 174: 51-6.
  • 11. Klein NC, Cunha BA. New antifungal drugs for pulmonary mycoses. Chest 1996; 110: 525-32.
  • 12. Wong PC, Fung SL, Lee J, Wong CF, et al. Chronic necrotizing pulmonary aspergillosis. A report of 9 cases with analysis of clinical picture, risk factors and treatment for outcome correlation. Monaldi Arch Chest Dis 2001; 56(3): 202-7
Toplam 12 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA87JR78GN
Bölüm Olgu Sunumu
Yazarlar

Sezen Şenirmak Özden Bu kişi benim

Gürkan Ertuğrul Bu kişi benim

Şevket Dereli Bu kişi benim

Can Binçmen Bu kişi benim

Rifat Özacar Bu kişi benim

Yayımlanma Tarihi 1 Ekim 2004
Yayımlandığı Sayı Yıl 2004 Cilt: 18 Sayı: 2

Kaynak Göster

APA Özden, S. Ş., Ertuğrul, G., Dereli, Ş., Binçmen, C., vd. (2004). SUBAKUT NEKROTİZAN PULMONER ASPERGİLLOZİS: OLGU SUNUMU. İzmir Göğüs Hastanesi Dergisi, 18(2), 83-88.