MUKORMİKOZİSLİ PANSİTOPENİK ÇOCUK HASTADA ZOR HAVAYOLU YÖNETİMİ: OLGU SUNUMU

Öz

Mukormikozis, Mucorales türü mantarların neden olduğu nadir, hızlı ilerleyen ve yüksek mortaliteli bir fungal enfeksiyondur. Genellikle immünsüprese bireylerde görülür ve rino-serebral, pulmoner, kutanöz, dissemine ve gastrointestinal olmak üzere farklı klinik formları vardır. Klinik tablo, tutulan organa göre değişiklik gösterir. Çocuklarda, özellikle hematolojik malignitesi veya kök hücre nakli sonrası immünsüpresyon varlığında mortalite belirgin şekilde artar. Üst hava yolu tutulumu olan olgularda perioperatif anestezi yönetimi ciddi zorluklar yaratır.

Anahtar Kelimeler

• Zor Havayolu
• Pediatrik anestezi
• Videolaringoskopi
• Bradikardi

DIFFICULT AIRWAY MANAGEMENT IN A PANCYTOPENIC CHILD WITH MUCORMYCOSIS: A CASE REPORT

Öz

Mucormycosis is a rare, rapidly progressive, high-mortality fungal infection caused by fungi of the Mucorales genus. It is usually seen in immunosuppressed individuals and has different clinical forms, including rhinocerebral, pulmonary, cutaneous, disseminated, gastrointestinal. The clinical presentation varies depending on the organ involved. Mortality increases significantly in children, especially in the presence of hematological malignancy or immunosuppression following stem cell transplantation. Perioperative anesthesia management poses significant challenges in cases with upper airway involvement.

Anahtar Kelimeler

• Difficult Airway
• Pediatric Anesthesia
• Videolaryngoscopy
• Bradycardia

Kaynakça

1. Ziaka M, Papakonstantinou E, Vasileiou E, Chorafa E, Antachopoulos C, Roilides E. Paediatric cutaneous mucormycosis: a case report and review of the literature. Mycoses. 2022 Jul;65(7):674682. doi:10.1111/myc.13452. Epub 2022 May 24.
2. Lynch JP 3rd, Fishbein MC, Abtin F, Zhanel GG. Part 1: Mucormycosis: prevalence, risk factors, clinical features, and diagnosis. Expert Rev Anti Infect Ther. 2023;21(7):723736. doi:10.1080/14787210.2023.2220964.
3. Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SCA, Dannaoui E, Hochhegger B, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the ECMM and MSG ERC. Lancet Infect Dis. 2019;19(12):e405e421. doi:10.1016/S1473-3099(19)30312-3.
4. El-Morsy GZ, Haj-Younes B, Abouleish E. Airway management in pediatric patients with difficult airways: an update. Paediatr Anaesth. 2020;30(7):705716. doi:10.1111/pan.13958.
5. Prabhu RM, Patel R. Mucormycosis and entomophthoramycosis: a review of the clinical manifestations, diagnosis and treatment. Clin Microbiol Infect. 2004;10 Suppl 1:3147. doi:10.1111/j.1469-0691.2004.00945.x.