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Aplastik Anemili Hastada Proflaksi Altında Gelişen Pnomosistis jirovejii Enfeksiyonu

Yıl 2015, Cilt: 15 Sayı: 2, 78 - 81, 01.04.2015
https://doi.org/10.5222/j.child.2015.078

Öz

Pnömosistis jirovejii PJ başta AIDS Acquired immune deficiency syndrome: AIDS olmak üzere immun yetmez- likli hastalarda enfeksiyona yol açabilen fırsatçı bir patojendir. Sağlıklı insanlarda görülmesi oldukça ender- dir. Diffüz intertisiyel pnömoni yapar, ciddi hipoksemi yapabilir ve fulminan seyir gösterebilir. Riskli hastalar- da Trimetoprim sülfometaksazol TMP-SMX proflaksisi önerilir. Bu makalede, anneden haploidentik kemik iliği nakli KİT planlanan aplastik anemi tanılı bir hastada gelişen Pnömosistis jirovejii pnömonisi PJP vakası sunuldu. Vaka uzun süredir TMP-SMX proflaksisi altın- daydı ve transfüzyon gereksinimi dışında hastane yatış öyküsü yoktu. Acil polikliniğe ani gelişen solunum sıkın- tısı ile başvurdu, takibinde hipoksi ve hızlı klinik bozul- ma ile mekanik ventilasyon gereksinimi gelişti. Alınan bronkoalveoler sıvı örneğinde Pnömosistis jirovejii sap- tadı. Mekanik ventilasyon ve destek tedavilerle klinik iyileşme sağlandı. Antibiyotik proflaksisi altındayken görülmesi proflaksinin etkinliğinin kolonizasyonu her zaman engelleyemediğini düşündürmektedir

Kaynakça

  • Shelhamerb Jr, moderator. Respiratory disease in the immun compromised patients. Ann Intern Med 1992:117;415-31. http://dx.doi.org/10.7326/0003-4819-117-5-415
  • Vavra J, Kucera K. Pneumocystis carinii Delanoe: its ultrastructure and ultra structural affinities. J Protozool 1970;17:463-83. http://dx.doi.org/10.1111/j.1550-7408.1970.tb04715.x
  • Stringer Jr, Walzer Pd. Molecular biology and epi- demiology of Pneumocystis carinii infection in AIDS. AIDS 1996;10:561-71. http://dx.doi.org/10.1097/00002030-199606000-00001
  • Frenkel JK. Pneumocystis. In: Binford CH, Connor DH, (eds). Pathology of tropical and extra ordinary diseases. Washington, DC: Armed Forces Institute of Pathology; 1976;303-7
  • Asai n, motojima S, ohkuni y, et al. Early diagnosis and treatment are crucial forthe survival of Pneumocystis pneumonia patients without human immunodeficiency virüs infection. J Infect Chemother 2012;18(6):898- 905. http://dx.doi.org/10.1007/s10156-012-0441-4
  • olsson m, Sukura A, Lindberg LA, et al. Detections of Pneumocystis carinii DNA by filtration of air. Scan J Infect Dis 1996;28:279-82. http://dx.doi.org/10.3109/00365549609027173
  • Lundgren B, Elvin K, rothman LP, et al. Transmission of Pneumocystis carinii from patients to hospital staff. Thorax 1997;52:422-4. http://dx.doi.org/10.1136/thx.52.5.422
  • rodriguez m, Fishman JA. Prevention of infection due to Pneumocystis spp. in human immuno deficiency virüs negative. Clin Microbiol Rev 2004;17(4):770-82
  • nevez G, Guyot K, Totet A, raccurt c, dei- cas E. Pulmonary colonisation with Pneumocystis carinii in an immunsupressed HIV negative patient: detection and typing of the fungus by PCR. J Med Microbiology 2001;50:198-200. http://dx.doi.org/10.1099/0022-1317-50-2-198
  • miller rF. Pneumocystiscariniiinfection in non AIDS patients. Current Opin Infec Dis 1999;12:371.
  • morris A, Wei K, Afshar K, Huang L. Epidemiology and clinical significance of Pneumo cystis colonizati- on. J Infect Dis 2008;197(1):10-7.
  • ng VL, yajko dm, Hadley WK. Extrapulmonary pneumocystosis. Clin Microbiol Rev 1997;10:401-18.
  • Vargas SL, Hughes WT, Santolaya mE, et al. Search for primary infection by Pneumocystis carinii in a cohort of normal, healthy infants. Clin Infect Dis 2001; 32:855-61. http://dx.doi.org/10.1086/319340
  • Wakefield AE, Stewart TJ, moxon Er, marsh K, Hopkin Jm. Infection with Pneumocystis carinii is prevalent in healthy Gambian children. Trans R Soc Trop Med Hyg1990; 84:800–2. http://dx.doi.org/10.1016/0035-9203(90)90087-U
  • yong SJ, Vuk-Pavlovic Z, Standing JE. Surfactant protein D-mediated aggregation of Pneumocystis cari- nii impairs phagocytosis by alveolar macrophages. Infect Immun 2003;71(4):1662-71. http://dx.doi.org/10.1128/IAI.71.4.1662-1671.2003
  • Hadley WK, Valerie LnG. Pneumocystis. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH (eds), Manuel of Clinical Microbiology, Washington: ASM Pres, 1999, 1200.
  • Hughes WT. Pneumocystis carinii pneumonia. In: Gorbach SL, Barlett JG, Blacklow NR (eds), Infectious Diseases. Philadelphia: W.B. Saunders Co, 1998;601.
  • Walzer Pd. Pneumocystis carinii. In: Mandell GL, Bennet JE, Dolin R, (eds) Principles and Practice of Infectious Diseases. New York: Churchill Livingstone; 1995, 2475.
  • nuesch r, Bellini c, Zimmerli W. Pneumocystis cari- nii pneumonia in human immuno deficiency virus (HIV)-positive and HIV-negative immuno compromi- sed patients. Clin Infect Dis 1999;29:1519-23. http://dx.doi.org/10.1086/313534
  • Ward mm, donald F. Pneumocystis carinii pneumo- nia in patients with connective tissue diseases: The role of hospital experience in diagnosis and mortality. Arthritis Rheum 1999;42:780-9. http://dx.doi.org/10.1002/1529-0131(199904) 42:43.0.CO;2-M
  • Bergin cJ, Wirth rL, Berry GJ. Pneumocystis cari- nii pneumonia: CT and HRCT observations. J Comput Assist Tomogr.1990;14:756-9. http://dx.doi.org/10.1097/00004728-199009000-00014
  • üner A, ok üZ, Korkmaz m. Pneumocystosis. In: Ozcel MA (ed). İmmün yetmezlikte önemi artan parazit hastalıkları. İzmir: Türk Parazitoloji Derneği 1999;12: 1-22
  • cushion mT, Linke mJ, Ashbaugh A, et al. Echinocandin treatment of Pneumocystis pneumonia in rodent models depletescysts leaving trophic burdens that cannot transmit the infection. PLoS One 2010; 5(1):e8524. http://dx.doi.org/10.1371/journal.pone.0008524
  • Kushima H, et al. Effects of sulfamethoxazole- trimethoprim on airway colonization with Pneumocystis jirovecii. Jpn J Infect Dis 2015.

Pneumocytis jiroveci Infection Developed in Aplastic Anemia Patients Under Prophylaxis

Yıl 2015, Cilt: 15 Sayı: 2, 78 - 81, 01.04.2015
https://doi.org/10.5222/j.child.2015.078

Öz

Pneumocystis jiroveci PJ is an opportunistic pathogen that can cause infection in immunocompromised patients, primarily in patients with AIDS Acquired Immune defici- ency syndrome . It is quite rare in healthy induviduals. It causes interstitial pneumonia, severe hypoxemia and may demonstrate a fulminant course. Trimethoprim- sulfamet- hoxazole TMP-SMX prophylaxis is recommended for risky patients. In this article, we present a patient with the diagnosis of aplastic anemia who developed pneumocystis jiroveji pneumonia PJP and scheduled for haploidentical bone marrow transplantation BMT from mother. The patient was under TMP-SMX prophylaxis for a long time and had no history of hospitalization except for the need for transfusion. He was admitted to the emergency depart- ment with sudden onset of respiratory distress, and during follow- up period he required mechanical ventilation due to hypoxia and rapid clinical deterioration. Bronchoalveolar fluid samples obtained showed the presence of Pneumocystis jirovecii. Clinical improvement was achieved with mecha- nical ventilation and supportive treatment. Colonization under antibiotic prophylaxis suggests that effectiveness of prophylaxis does not always prevent colonization

Kaynakça

  • Shelhamerb Jr, moderator. Respiratory disease in the immun compromised patients. Ann Intern Med 1992:117;415-31. http://dx.doi.org/10.7326/0003-4819-117-5-415
  • Vavra J, Kucera K. Pneumocystis carinii Delanoe: its ultrastructure and ultra structural affinities. J Protozool 1970;17:463-83. http://dx.doi.org/10.1111/j.1550-7408.1970.tb04715.x
  • Stringer Jr, Walzer Pd. Molecular biology and epi- demiology of Pneumocystis carinii infection in AIDS. AIDS 1996;10:561-71. http://dx.doi.org/10.1097/00002030-199606000-00001
  • Frenkel JK. Pneumocystis. In: Binford CH, Connor DH, (eds). Pathology of tropical and extra ordinary diseases. Washington, DC: Armed Forces Institute of Pathology; 1976;303-7
  • Asai n, motojima S, ohkuni y, et al. Early diagnosis and treatment are crucial forthe survival of Pneumocystis pneumonia patients without human immunodeficiency virüs infection. J Infect Chemother 2012;18(6):898- 905. http://dx.doi.org/10.1007/s10156-012-0441-4
  • olsson m, Sukura A, Lindberg LA, et al. Detections of Pneumocystis carinii DNA by filtration of air. Scan J Infect Dis 1996;28:279-82. http://dx.doi.org/10.3109/00365549609027173
  • Lundgren B, Elvin K, rothman LP, et al. Transmission of Pneumocystis carinii from patients to hospital staff. Thorax 1997;52:422-4. http://dx.doi.org/10.1136/thx.52.5.422
  • rodriguez m, Fishman JA. Prevention of infection due to Pneumocystis spp. in human immuno deficiency virüs negative. Clin Microbiol Rev 2004;17(4):770-82
  • nevez G, Guyot K, Totet A, raccurt c, dei- cas E. Pulmonary colonisation with Pneumocystis carinii in an immunsupressed HIV negative patient: detection and typing of the fungus by PCR. J Med Microbiology 2001;50:198-200. http://dx.doi.org/10.1099/0022-1317-50-2-198
  • miller rF. Pneumocystiscariniiinfection in non AIDS patients. Current Opin Infec Dis 1999;12:371.
  • morris A, Wei K, Afshar K, Huang L. Epidemiology and clinical significance of Pneumo cystis colonizati- on. J Infect Dis 2008;197(1):10-7.
  • ng VL, yajko dm, Hadley WK. Extrapulmonary pneumocystosis. Clin Microbiol Rev 1997;10:401-18.
  • Vargas SL, Hughes WT, Santolaya mE, et al. Search for primary infection by Pneumocystis carinii in a cohort of normal, healthy infants. Clin Infect Dis 2001; 32:855-61. http://dx.doi.org/10.1086/319340
  • Wakefield AE, Stewart TJ, moxon Er, marsh K, Hopkin Jm. Infection with Pneumocystis carinii is prevalent in healthy Gambian children. Trans R Soc Trop Med Hyg1990; 84:800–2. http://dx.doi.org/10.1016/0035-9203(90)90087-U
  • yong SJ, Vuk-Pavlovic Z, Standing JE. Surfactant protein D-mediated aggregation of Pneumocystis cari- nii impairs phagocytosis by alveolar macrophages. Infect Immun 2003;71(4):1662-71. http://dx.doi.org/10.1128/IAI.71.4.1662-1671.2003
  • Hadley WK, Valerie LnG. Pneumocystis. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH (eds), Manuel of Clinical Microbiology, Washington: ASM Pres, 1999, 1200.
  • Hughes WT. Pneumocystis carinii pneumonia. In: Gorbach SL, Barlett JG, Blacklow NR (eds), Infectious Diseases. Philadelphia: W.B. Saunders Co, 1998;601.
  • Walzer Pd. Pneumocystis carinii. In: Mandell GL, Bennet JE, Dolin R, (eds) Principles and Practice of Infectious Diseases. New York: Churchill Livingstone; 1995, 2475.
  • nuesch r, Bellini c, Zimmerli W. Pneumocystis cari- nii pneumonia in human immuno deficiency virus (HIV)-positive and HIV-negative immuno compromi- sed patients. Clin Infect Dis 1999;29:1519-23. http://dx.doi.org/10.1086/313534
  • Ward mm, donald F. Pneumocystis carinii pneumo- nia in patients with connective tissue diseases: The role of hospital experience in diagnosis and mortality. Arthritis Rheum 1999;42:780-9. http://dx.doi.org/10.1002/1529-0131(199904) 42:43.0.CO;2-M
  • Bergin cJ, Wirth rL, Berry GJ. Pneumocystis cari- nii pneumonia: CT and HRCT observations. J Comput Assist Tomogr.1990;14:756-9. http://dx.doi.org/10.1097/00004728-199009000-00014
  • üner A, ok üZ, Korkmaz m. Pneumocystosis. In: Ozcel MA (ed). İmmün yetmezlikte önemi artan parazit hastalıkları. İzmir: Türk Parazitoloji Derneği 1999;12: 1-22
  • cushion mT, Linke mJ, Ashbaugh A, et al. Echinocandin treatment of Pneumocystis pneumonia in rodent models depletescysts leaving trophic burdens that cannot transmit the infection. PLoS One 2010; 5(1):e8524. http://dx.doi.org/10.1371/journal.pone.0008524
  • Kushima H, et al. Effects of sulfamethoxazole- trimethoprim on airway colonization with Pneumocystis jirovecii. Jpn J Infect Dis 2015.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makaleleri
Yazarlar

Selime Aydoğdu Bu kişi benim

Serap Karaman Bu kişi benim

Deniz Tuğcu Bu kişi benim

Hacer Aktürk Bu kişi benim

Zeynep Karakaş Bu kişi benim

Onkoloji Bilim Dal Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 15 Sayı: 2

Kaynak Göster

APA Aydoğdu, S., Karaman, S., Tuğcu, D., Aktürk, H., vd. (2015). Aplastik Anemili Hastada Proflaksi Altında Gelişen Pnomosistis jirovejii Enfeksiyonu. Journal of Child, 15(2), 78-81. https://doi.org/10.5222/j.child.2015.078
AMA Aydoğdu S, Karaman S, Tuğcu D, Aktürk H, Karakaş Z, Dal OB. Aplastik Anemili Hastada Proflaksi Altında Gelişen Pnomosistis jirovejii Enfeksiyonu. Journal of Child. Nisan 2015;15(2):78-81. doi:10.5222/j.child.2015.078
Chicago Aydoğdu, Selime, Serap Karaman, Deniz Tuğcu, Hacer Aktürk, Zeynep Karakaş, ve Onkoloji Bilim Dal. “Aplastik Anemili Hastada Proflaksi Altında Gelişen Pnomosistis Jirovejii Enfeksiyonu”. Journal of Child 15, sy. 2 (Nisan 2015): 78-81. https://doi.org/10.5222/j.child.2015.078.
EndNote Aydoğdu S, Karaman S, Tuğcu D, Aktürk H, Karakaş Z, Dal OB (01 Nisan 2015) Aplastik Anemili Hastada Proflaksi Altında Gelişen Pnomosistis jirovejii Enfeksiyonu. Journal of Child 15 2 78–81.
IEEE S. Aydoğdu, S. Karaman, D. Tuğcu, H. Aktürk, Z. Karakaş, ve O. B. Dal, “Aplastik Anemili Hastada Proflaksi Altında Gelişen Pnomosistis jirovejii Enfeksiyonu”, Journal of Child, c. 15, sy. 2, ss. 78–81, 2015, doi: 10.5222/j.child.2015.078.
ISNAD Aydoğdu, Selime vd. “Aplastik Anemili Hastada Proflaksi Altında Gelişen Pnomosistis Jirovejii Enfeksiyonu”. Journal of Child 15/2 (Nisan 2015), 78-81. https://doi.org/10.5222/j.child.2015.078.
JAMA Aydoğdu S, Karaman S, Tuğcu D, Aktürk H, Karakaş Z, Dal OB. Aplastik Anemili Hastada Proflaksi Altında Gelişen Pnomosistis jirovejii Enfeksiyonu. Journal of Child. 2015;15:78–81.
MLA Aydoğdu, Selime vd. “Aplastik Anemili Hastada Proflaksi Altında Gelişen Pnomosistis Jirovejii Enfeksiyonu”. Journal of Child, c. 15, sy. 2, 2015, ss. 78-81, doi:10.5222/j.child.2015.078.
Vancouver Aydoğdu S, Karaman S, Tuğcu D, Aktürk H, Karakaş Z, Dal OB. Aplastik Anemili Hastada Proflaksi Altında Gelişen Pnomosistis jirovejii Enfeksiyonu. Journal of Child. 2015;15(2):78-81.