Diyabetes Mellitusda Kriptokok ve Mukor ile Birlikte Görülen Bir Rhino-Orbital Mukormikoz Olgusu

Öz

AbstractA Case of Rhino-Orbital Mucormycosis with Cryptococcus & Mucor in Diabetes Mellitus Mucormycosis is a severe fungal infection which has mortal course in immunosuppressive patients. Zygomycetes, aspergilli and other fungi existing in the environment may be the causative agents in this fungal infection with high morbidity and mortality especially in diabetic patients. Early diagnosis and management prolong survival in mucormycosis cases. The case presented in this paper is about a mixed mucormycosis case caused by zygomycetes and Criptococcus laurentii, which rarely infect human. It is the first one to be reported in literature. The case was a 52 years old female patient with diabetes mellitus type 2 for 15 years and had a splenectomy 3 years ago. She had necrosis on palate and loss of vision due to right optic perineuritis. Despite the appropriate treatment and surgical debridement, the patient was lost because of secondary nosocomial infection to pneumonia. In this case report we aim to emphasize the importance of early diagnosis and treatment as well as the devastating effect of probable serious nosocomial pneumonia on survival of diabetic patients with fungal infections and to present the mucormycosis with two different agents.

Anahtar Kelimeler

• mucormycosis; diabetes mellitus; splenectomy; Criptococcus laurentii

Diyabetes Mellitusda Kriptokok ve Mukor ile Birlikte Görülen Bir Rhino-Orbital Mukormikoz Olgusu

Öz

Türkçe Özet: Mukormikozis immunsüpressif hastalarda mortal seyreden ciddi bir mantar enfeksiyonudur. Özellikle diyabetik hastalarda morbidite ve mortalitesi yüksek olan bu fungal enfeksiyonda ortamda bulunan zigomiçetler, aspergillozlar ve diğer mantarlar etken olabilir. Mukormikoz olgularında erken tanı ve tedavi yaşam süresini uzatır. Bu yazıda, insanda çok nadir enfeksiyon yapan ve ilk defa olarak Criptococcus laurentii ve zigomiçete bağlı miks bir mukormikoz olgusu tanımlandı. Olgu onbeş yıldan beri tip 2 diyabet ve üç yıl önce splenektomisi yapılmış 52 yaşında bir bayan hasta idi. Hastanın damakta nekrozu ve sağ optik perinörite bağlı görme kaybı vardı. Uygun tedavi ve cerrahi debridmana rağmen hasta gelişen sekonder nozokomiyal pnömoni sonucu kaybedildi. Bu sunumun amacı diyabetik hastalarda fungal enfeksiyonların erken tanı ve tedavisinin yanı sıra, gelişecek ciddi nozokomiyal pnömonilerinde yaşam süresini olumsuz etkileyebileceğine dikkat çekmek ve iki farklı mantar enfeksiyonu görülen bir mukor olgusunu sunmaktır.

Anahtar Kelimeler

• mukormikozis; diyabetes mellitus; splenektomi; Criptococcus laurentii

Kaynakça

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