Öz
Solid organ nakli (SOT) alıcılarında, invazif mantar enfeksiyonları (İFİ) önemli bir morbidite ve mortalite nedenidir. Bu nedenle, bu enfeksiyonların tanı, tedavi ve yönetimi büyük önem taşımaktadır. Bu olgu serisinde, yaşları 35-66 arasında değişen dokuz SOT alıcısında (dört böbrek, dört karaciğer ve bir kalp nakli) on bir farklı İFİ (beş kandidemi, üç aspergilloz, bir kriptokokkoz, bir intraabdominal mukormikoz ve bir Magnusiomyces enfeksiyonu) izlendi. Mukormikoz tanısı patoloji test sonucuyla; diğer mantarlar kültür yoluyla tanımlanmıştır. Kandidemisi olan (Candida parapsilosis) bir hastada tedavi altındayken flukonazole karşı direnç gelişmiştir. Çalışma hastaları, uzun süreli hastanede yatış, immünsüpresyon, geniş spektrumlu antibiyotik kullanımı, renal replasman tedavisi, santral venöz kateter, önceden antifungal maruziyeti ve reoperasyon dahil olmak üzere İFİ'ler için çeşitli risk faktörlerine sahipti. Tüm hastalarda varsa kateter çekilerek lokal kontrol sağlanmaya çalışılmıştır. Tedaviler, varsa antifungal duyarlılık sonuçlarına göre veya kılavuz önerilerine uygun olarak uygulanmıştır. Takip süresi boyunca, dokuz çalışma hastasından altısı (%66,7) ölmüştür. Uygun antifungal tedavi ve hasta yönetimine rağmen, İFİ'lerin mortalite oranı yüksek kalmaya devam etmektedir. Bu nedenle, hızlı tanı, uygun tedavi ve lokal kontrolü içeren multidisipliner bir yaklaşım esastır.
Anahtar Kelimeler: İnvaziv fungal enfeksiyonlar, aspergillozis, kandidemi, organ transplantasyonu
Kaynakça
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