Çocuklarda aspergillus enfeksiyonları

Aspergillus türleri doğada yaygın olarak bulunurlar. İnsanlarda invaziv hastalık, invaziv olmayan hastalık ve aşırı duyarlılık sendromu olmak üzere üç farklı hastalık grubuna neden olurlar. Çok sayıda türü olmasına karşın insanlardaki enfeksiyonlardan başlıca Aspergillus fumigatus ve Aspergillus flavus sorumludur. Özellikle bağışıklık sisteminde sorun olan hastalarda ortaya çıkan invaziv enfeksiyonların mortalitesi yüksektir. Antibiyotiklere yanıt vermeyen ateş genellikle ilk klinik bulgudur. Tanı mantarın kültürde üretilmesi, dokuda tipik hif yapısının gösterilmesi veya serolojik testler ile konulabilir. Tedavide amfoterisin B, itrakonazol ve flusitozin en sık kullanılan ilaçlardır. Kaspofungin ve vorikonazol gibi yeni ilaçlar çocuk hastaların tedavisinde umut vericidir.

Aspergillus infections in children

Aspergillus species are widespread in nature. They cause three different diseases, including invasive disease, non-invasive disease and hypersensitivity syndromes. Although they have many species, Aspergillus fumigatus and Aspergillus flavus are mainly responsible for human infections. Invasive infections in the immunocompromised patients cause particularly high mortality. Persistent fever not responding to antibiotics is usually the first clinical finding. The diagnosis can be established by the isolation of the fungus in culture, the demonstration of typical hyphea in the tissue samples, or serological tests. Amphotericin B, itraconazole, and flucytosine are the most commonly used drugs for the therapy. New drugs such as caspofungin and voriconazole are promising for the treatment of the pediatric patients.

Kaynakça

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