İlaç Alerjisi Gelişen Ürogenital Tüberküloz Vakası: Olgu Sunumu

Öz

Tüberküloz basilinin inhalasyonu, immün yanıtın uyarılmasıyla etkenin temizlenmesi ya da primer enfeksiyon oluşumu ile sonuçlanır. Primer tüberküloz enfeksiyonu, olguların %95’inde sessiz seyreder ve latent döneme girer. Olguların %5'inde ise primer tüberküloz hastalığına neden olur. Bu evrede mikobakteriler hematojen, lenfojen yol ile çevre dokulara ve akciğer dışı organlara yerleşebilir. Akciğer dışındaki odaklarda reaktivasyon olursa ekstrapulmoner tüberküloz ortaya çıkmaktadır. Ürogenital tüberküloz (ÜG-TB); plevral tüberküloz ve periferal lenfadenopatiden sonra en sık karşılaşılan ekstrapulmoner tüberküloz şeklidir. Böbrekler genellikle basilin akciğerden hematojen yol ile yayılması sonucu enfekte olmaktadır. Akciğer röntgenogramında, ÜG-TB vakalarının yaklaşık yarısında spesifik bulgu izlenmemektedir. Tedavi edilmemiş olgular renal parankim hasarı ve obstrüktif nefropati ile birlikte son dönem böbrek yetmezliğine sebep olabilir. Bu olgumuzda ürogenital tüberküloz tanısı almış hastada bir ilaç yan etkisi olarak gelişen hipersensitivite reaksiyonu ve bunun yönetiminden bahsedilmiştir.

Anahtar Kelimeler

• Ürogenital tüberküloz
• ekstrapulmoner tüberküloz
• ilaç yan etkisi

Case Report: Management of Adverse Drug Reaction in Patient with Urogenital Tuberculosis

Öz

Inhalation of tuberculosis bacillus triggers immune response and as a result it causes elimination of the causetive agent or it may end up with the manifestation of primary infection. In most of the cases, %95 of primary tuberculosis infection results in containment and enters the latent period whereas around %5 of the cases result progressive primary tuberculosis, at this stage mycobacterium may spread to adjacent and extrapulmonary tissues via hematogenous and lymphatic spread. If reactivation occurs in foci out of lungs, then extrapulmonary tuberculosis arises. Urogenital tuberculosis (UG-TB) is the third most common site of extrapulmonary tuberculosis following pleural tuberculosis and peripheral lympadenopathy. Kidneys are usually infected via hemotogenous spread of the bacillus from the lungs. Chest radiograph reveals no specific findings in almost half of the UG-TB cases. Untreated disease may result renal parenchyma damage and obstructive nephropathy and as a result end-stage renal disease occurs. In this case it is mentioned about hypersensitivity drug reaction that occured in patient with the diagnosis of urogenital tuberculosis.

Anahtar Kelimeler

• Urogenital tuberculosis
• extrapulmonary tuberculosis
• adverse drug reaction

Kaynakça

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