Utku AYGÜNEŞ, Fatih BOLAT, Fatma DUKSAL, Ömer CEVİT, Mehmet Burhan OFLAZ

Salmonella ishali olan immün yetmezlikli bir olguda oral immünoglobulin tedavisi

Enfeksiyon ilişkili gastroenteritte en sık tanımlanan patojen virüslerden sonra salmonelladır.Salmonellaya bağlı enfeksiyonlarda akut faz reaktanlarında artış ve ateş daha fazla görülmektedir.Salmonella enteropatojenik gram negatif basil olup lokalize enfeksiyondan sistemik enfeksiyonakadar değişen enfeksiyonlara yol açabilmektedir. En sık görülen şekli kendini sınırlayan komplikeolmayan gastroenterittir. Rotavirüs ishali de Salmonella ishali gibi genel olarak kendini sınırladığıhalde, bağışıklık sistemi baskılanmış hastalarda daha uzun ve ciddi seyredebilir. Daha çokrotavirüs ishallerinde yapılan çalışmalarda, verilen oral immünoglobulinin ishal süresini,semptomların şiddetini ve viral atılımı azalttığı gösterilmiştir. Salmonella ishalinde oralimmünoglobilin verildiğini gösteren bir çalışmaya rastlamadık. Bu sunumda bağışıklık sistemibaskılanmış bir olguda Salmonellaya bağlı ağır ishalin oral immünoglobulin ile tedavisitartışılmıştır.

Oral human serum immunoglobulin treatment in an immunocompromised patient with Salmonella diarrhea

The most frequently identified pathogen, after viral pathogens, associated with infectiousgastroenteritis is Salmonella. Increase in acute-phase reactants and fever are more frequently seendue to Salmonella infection. Salmonella, which is an enteropathogenic gram-negative bacillicauses infections ranging from localized to systemic infection. The most common form ofSalmonella infection is uncomplicated self-limited gastroenteritis. In general, although rotavirusdiarrhea like Salmonella diarrhea is limited by itself, it may cause a long and severe diarrhea inimmunosuppressed patients. In the studies which have been done more with rotavirüs diarrhea, itwas seen that, oral immunoglobulin reduced the severity of symptoms and of viral excretion. Wedid not find a study showing given oral immünogobilin in Salmonella diarrhea. In this presentationit is discussed oral immunoglobulin treatment in an immunosuppressed patient who had severediarrhea due to Salmonella infection.

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