Öz
Giriş
Visseral leishmaniasis (VL), sistemik bir protozoan vektör kaynaklı hastalıktır ve tedavi edilmediği takdirde ölümcül sonuçlara yol açan en ciddi leishmaniasis klinik formunu temsil eder. Bu çalışma, VL hastalarında temel epidemiyolojik, klinik ve laboratuvar bulgularını, tedavi seçeneklerini ve sonuçları değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem
2001-2023 yılları arasında Kuzey Makedonya Cumhuriyeti, Üsküp Üniversitesi Enfeksiyon Hastalıkları Hastanesi’nde (RNM) VL tanısı konulan ve tedavi edilen 84 hastanın epidemiyolojik ve klinik özellikleri retrospektif olarak analiz edilmiştir.
Bulgular
Hastaların ortanca yaşı 47 yıl (1-74) olup, %77,4’ü erkektir. Vakaların %41,7’sinde köpeklerle temas bildirilmiştir. Hastaların %7’sinde bağışıklık sistemi baskılanmıştı ve tamamı Insan Immün Yetmezlik Virüsü negatifti. Semptom başlangıcından tanıya kadar geçen ortanca süre 30 gündü (aralığı 4-330 gün). Baskın klinik bulgular; splenomegali (%97,6), ateş (%96,4), hepatomegali (%90,5) ve kilo kaybı (%54,8) idi. Başvuru sırasında hastaların sırasıyla %75’inde anemi, %73,8’inde lökopeni, %70,2’sinde trombositopeni ve %63,1’inde hipergamaglobulinemi tespit edildi. Vakaların %91,7’sinde olumlu sonuç elde edildi; %1,2’sinde tedavi başarısızlığı meydana geldi ve hastaların %7,1’i hayatını kaybetti.
Sonuç
Uzun süreli açıklanamayan ateş, splenomegali, sitopeni ve hipergamaglobulinemi ile başvuran ve RNM’den gelen hastalarda VL önemli bir ayırıcı tanı olarak düşünülmelidir.
Anahtar Kelimeler: Visseral leishmaniasis, ateş, splenomegali, sitopeni, tedavi
Kaynakça
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