Geç Tanı Alan HIV ile Yaşayan Kişide Fırsatçı Enfeksiyonlara Multidisipliner Yaklaşım

A. Rasheed BAHAR; Yasemin BAHAR; Serkan UYSAL; Meliḣ a Çağla SÖNMEZER; Dolunay GÜLMEZ; Sevgen ÇELİK ÖNDER; Mehmet Ruhi ̇ONUR; Sevtap ARIKAN AKDAĞLI; Ahmet ÇAĞKAN İNKAYA; Dilara İNAN; Serhat ÜNAL

doi:10.4274/mjima.galenos.2022.2021.23

Geç Tanı Alan HIV ile Yaşayan Kişide Fırsatçı Enfeksiyonlara Multidisipliner Yaklaşım

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Geç Tanı Alan HIV ile Yaşayan Kişide Fırsatçı Enfeksiyonlara Multidisipliner Yaklaşım

Mediterr J Infect Microb Antimicrob 2022;11:23-23 DOI: 10.4274/mjima.galenos.2022.2021.23

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İzin

Öz

Fırsatçı enfeksiyonlar özellikle antiretroviral tedavi almayan İnsan immün yetmezlik virüsü (HIV) ile yaşayan kişilerde (HYK) hala önemli bir morbidite ve mortalite sebebidir. Öte yandan, mental durumunda değişme olan ve normal dışı nörolojik muayene bulguları ile başvuran HYK’lerin değerlendirilmesi ve yönetimi spesifik olmayan bulgu ve semptomlardan dolayı zorlayıcıdır. İnsan immün yetmezlik virüsü ile yaşayan kişilerde Sitomegalovirüs (CMV) ilişkili nörolojik bozukluklar nadir olsa da, bazı olgularda ölümcül ensefalite sebep olabilir. Sitomegalovirüs retiniti, tanının uygun klinik tablo ile konulduğu, HYK’lerde diğer ciddi bir durumdur. Bu olgu raporunda mental durumunda değişme ve yaygın nörolojik şikayetleri olan ve sonrasında HIV ile yaşayan olduğu anlaşılan orta yaşlı bir erişkin olgu sunulmuştur. İleri klinik ve radyolojik değerlendirme sonucunda HIV ilişkili nörokognitif bozukluk zemininde gelişen CMV ensefaliti gösterilmiştir. Takip sürecinde AIDS ilişkili invaziv pulmoner aspergilloz ve fungus topu geliştiren olguya, radyoloji ve göğüs cerrahi bölümleri ile konsülte edilerek pulmoner lobektomi uygulanmştır. Sonuç olarak, bu olgu çok sayıda organ sisteminin tutulumuna bağlı olarak değişik klinik özellikler gösteren ve çok sayıda laboratuvar ve radyolojik inceleme gerektirebilecek HYK’lere multidisipliner yaklaşımın önemini vurgulamaktadır.

Anahtar Kelimeler: AIDS, fırsatçı enfeksiyonlar, ART

Kaynakça

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