Özlem KANDEMİR, Kemal GÖRÜR, Elif ŞAHİN, Cengiz ÖZCAN, Düşmez Duygu APA

The probable role of desferrioxamine for rhinocerebral mucormycosis in a diabetic patient

Mukormikozis, Mucorales sınıfındaki mantarların neden olduğu infeksiyonu tanımlar. Bu mantarlar, duyarlı konakta özellikle diabetik, asidotik, immünyetmezlikli ve desferrioksamin tedavisi alanlarda ciddi seyirli hastalığa neden olabilirler. Rinoserebral mukormikozis bu mantarların neden olduğu klinik bir formdur. Hastalığın bu formu tedavi edilmezse hızlı ilerler ve ölüme neden olabilir. Rinoserebral mukormikozis gelişiminde diabetik ketoasidoz tek başına hiperglisemiden daha önemlidir. İmmün yetmezliğe neden olan diğer hastalıklar da varsa hastalığın prognozu kötüdür. Bu olgu sunumunda, nonasidotik diabetik ve miyelodisplastik sendromla ilişkili rinoserebral mukormikozis tanısı olan bir hasta sunulmuştur. Sunulan olguda yüksek serum demir düzeyini azaltmak için desferrioksamin tedavisi uygulanmaktaydı. Agresif tedavi uygulandığı halde olgunun hastalığı hızlı ilerledi ve hasta kaybedildi.

Anahtar Kelimeler:

Mukormikozis, Diabetes mellitus, Ölümle sonuçlanma, Erkek, Yaşlı, Deferoksamin

Diabetik bir hastada rinoserebral mukormikozis gelişiminde desferrioksaminin olası rolü

Mucormycosis is the term for infections caused by fungi of the order Mucorales. These fungi may produce a severe disease in susceptible individuals, notably immunocompromised patients with diabetes, acidosis and receiving desferrioxamine. Rhinocerebral mucormycosis is a clinical form which is caused by these fungi. If this form of the disease is not treated, it can rapidly progress and cause death. Diabetic ketoacidosis is more important than hyperglycemia alone in rhinocerebral mucormycosis. If the other diseases which cause immunodeficiency are also present, the prognosis of the disease is worse. This case report describes a patient who is diagnosed as rhinocerebral mucormycosis associated with non acidotic diabetes and myelodysplastic syndrome. This case also was administered desferrioxamine to decrease the elevated serum iron level. The di-sease rapidly progressed and patient died although aggressive therapy (surgical and medical) was performed.

Keywords:

Mucormycosis, Diabetes Mellitus, Fatal Outcome, Male, Aged, Deferoxamine,

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