İlk doz kolistin kullanımı sonrasında kolistine bağlı olarak nöropati gelişen bir olgu

Yıl 2021, , 25 - 27, 23.03.2021

Fatoş Ersoy , Salih Cesur , Gunay Tuncer Ertem , Kader Arslan , Gülşah Gelişigüzel , Cigdem Ataman Hatipoglu , Sami Kınıklı

https://doi.org/10.47582/jompac.785044

Öz

Kateter enfeksiyonlarının en sık etkeni cilt florasında yer alan stafilokoklar ve diğer Gram-pozitif bakterilerdir. Citrobacter freundii çoğunlukla nozokomiyal enfeksiyon etkeni olup, nadiren kateterle ilişkili kan dolaşımı enfeksiyonuna neden olur. Bu yazıda, hemodiyalize giren 39 yaşında bir erkek hastada Citrobacter freundii’ye bağlı olarak gelişen kateterle kan dolaşımı enfeksiyonu gelişen bir olgu sunuldu. Hastanın periferik kan ve kateter içinden alınan kan örneklerinde Citrobacter freundii üredi. Hastaya 10 gün süreyle seftriakson tedavisi uygulandı, tedavi sonrası klinik ve laboratuvar bulguları düzeldi. Sonuç olarak, özellikle hemodiyalize giren hastalarda nadirde olsa Gram-negatif bakterilerden Citrobacter freundii’nin de kateterle ilişkili kan dolaşımı enfeksiyonu etkeni olabileceği akılda tutulmalıdır.

Anahtar Kelimeler

Çoğul ilaca dirençli, K.pneumoniae, , kolistin, yan etki, nörotoksisite

A case with neuropathy due to colistin after using first dose of colistin

Öz

Colistin is an antibiotic commonly used in the treatment of infection due to multiple drug resistant Gram negative bacilli. Colistin side effects include of nephropathy and neuropathy. Neurotoxicity due to colistin can be occur as paresthesia, dizziness, visual changes, and neuromuscular blockade with ataxia. In this article, a case of 68-year-old female patient with a diagnosis of urinary tract infection due to resistant Klebsiella pneumoniae and treatment of imipenem and colistin after the first dose of colistin and her treatment colistin was stoped upon the development of paresthesia in the lips and fingers. After discontinuation of the drug, the patient's paresthesia improved, and the treatment was continued with a combination of imipenem and trimethoprim-sulfomethoxazole.
As a result, patients receiving colistin therapy should be closely monitored for symptoms of neuropathy and drug therapy should be discontinued if neurotoxicity develops.

Anahtar Kelimeler

Multidrug resistance, Klebsiella.pneumoniae, colistin, side effect, neurotoxicity

Kaynakça

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